Sinonasal undifferentiated carcinoma: clinicopathological spectrums and diagnosis reappraisal

Hum Pathol. 2019 Jul:89:62-70. doi: 10.1016/j.humpath.2019.04.008. Epub 2019 May 3.

Abstract

Sinonasal undifferentiated carcinoma (SNUC) is defined as undifferentiated carcinoma of the sinonasal tract without glandular or squamous features and not otherwise classifiable. SNUC is a rare tumor, with a long list of differential diagnoses, and often poses a considerable diagnostic challenge. In addition, recent advances in molecular and immunohistochemistry techniques have recognized several new entities that were previously included in the SNUC category. These include SMARCB1 (INI-1)-deficient carcinoma, NUT (nuclear protein in testis) carcinoma, adamantinoma-like Ewing sarcoma, and the most recently described and rarer SMARCA4 (BRG)-deficient carcinoma. In this study, we retrospectively reviewed 11 cases with an original diagnosis of SNUC. We found that a significant portion of those cases can be reclassified into specific entities, with potential impact on therapy and prognosis because of misclassification in 2 of these cases.

Keywords: Neuroendocrine carcinoma; SMARCA4 (BRG1); SMARCB1 (INI-1); SMARCB1-deficient sinonasal carcinoma; Sinonasal undifferentiated carcinoma (SNUC).

MeSH terms

  • Adult
  • Aged
  • Carcinoma / classification
  • Carcinoma / diagnosis*
  • Carcinoma / pathology*
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Maxillary Sinus Neoplasms / classification
  • Maxillary Sinus Neoplasms / diagnosis*
  • Maxillary Sinus Neoplasms / pathology*
  • Middle Aged
  • Paranasal Sinus Neoplasms / classification
  • Paranasal Sinus Neoplasms / diagnosis
  • Paranasal Sinus Neoplasms / pathology
  • Retrospective Studies
  • Young Adult

Supplementary concepts

  • Sinonasal undifferentiated carcinoma