Nasal cavity, paranasal sinuses, nasopharynx
Sinonasal adenocarcinoma
Nonintestinal type
Last author update: 1 August 2013
Last staff update: 26 May 2023 (update in progress)
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PubMed Search: Nonintestinal type adenocarcinoma
Table of Contents
Definition / general | Epidemiology | Sites | Etiology | Clinical features | Prognostic factors | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Mannan R, Yuan S. Nonintestinal type. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/nasalLGseromucinous.html. Accessed June 4th, 2023.
Definition / general
- Also known as low grade (seromucinous) sinonasal adenocarcinoma (Head Neck Pathol 2010;4:77)
- Presumed seromucous gland origin
Epidemiology
- Wide age range, mean age of 37 - 53 years at presentation
- No gender predilection
Sites
- Anywhere in sinonasal tract; but nasal cavity is most commonly affected, followed by ethmoid and maxillary sinuses (J Clin Pathol 2009;62:1085)
Etiology
- No known risk factors, predisposing conditions or environmental exposures identified
Clinical features
- Presents primarily with nasal obstruction and epistaxis
- Pain is uncommon
Prognostic factors
- Excellent prognosis
- Most patients have localized disease at presentation, local recurrence has been reported but metastasis is rare
- Rare reports of death due to local invasion (Cancer 1982;50:312)
Case reports
- 17 year old boy with nasal mass (Ann Diagn Pathol 2011;15:181)
- 32 year old man with TTF1+ low grade tubulopapillary adenocarcinoma of sinonasal tract (World J Surg Oncol 2008;6:54)
- 64 year old woman with papillary seromucinous carcinoma of eustachian tube (J Otolaryngol Head Neck Surg 2013;42:12)
Treatment
- Complete surgical excision
- Radiotherapy reserved for extensive disease
Clinical images
Images hosted on other servers:
Eustachian tube tumor
Gross description
- Variable; well demarcated to poorly defined, flat to exophytic or papillary growth with tan / white to pink color and friable to firm consistency
Microscopic (histologic) description
- Morphologically heterogeneous
- Mostly glandular or papillary patterns (Head Neck Pathol 2007;1:38)
- Other morphologic variants include clear cell (Arch Otolaryngol Head Neck Surg 2002;128:441), cribriform, mucinous, trabecular
- Commonly compact acini, back to back glands, cystic dilatation; some cases show intraglandular mucin
- Tumor cells exhibit uniform morphology, with abundant cytoplasm, mild to moderate nuclear atypia, inconspicuous nucleoli
- Rare mitotic figures, no atypical mitoses, no necrosis
Microscopic (histologic) images
Images hosted on other servers:
Bland serous glands
Complex papillary growth pattern
Tubulopapillary pattern
Eustachian tube tumor
TTF1+ case
Positive stains
Negative stains
Differential diagnosis
- Intestinal type adenocarcinoma: high cytologic grade; CK20+, CK7-, CDX2+, villin+ (Ann Diagn Pathol 2011;15:181)
- Metastatic papillary carcinoma of thyroid: thyroglobulin+
- Oncocytic Schneiderian papilloma
- Respiratory epithelial adenomatoid hamartoma: predilection for posterior nasal septum; lobular growth pattern; absence of complex glandular architecture (Am J Surg Pathol 2009;33:401)
