Sinonasal (Schneiderian) Tumors in the Temporal Bone: Case Series and Systematic Review

Francis Deng; Peter M Sadow; Nabeeha Khan; Xin Wu; Ivan H El-Sayed; David H Jung; Christine M Glastonbury; Amy F Juliano

doi:10.3174/ajnr.A8146

Sinonasal (Schneiderian) Tumors in the Temporal Bone: Case Series and Systematic Review

AJNR Am J Neuroradiol. 2024 Feb 15. doi: 10.3174/ajnr.A8146. Online ahead of print.

Authors

Francis Deng¹, Peter M Sadow^{2

3}, Nabeeha Khan⁴, Xin Wu⁵, Ivan H El-Sayed⁶, David H Jung³, Christine M Glastonbury⁵, Amy F Juliano⁷

Affiliations

¹ From the Russell H. Morgan Department of Radiology and Radiological Science (F.D.), Johns Hopkins University, Baltimore, Maryland.
² Department of Pathology (P.M.S.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
³ Department of Otolaryngology-Head and Neck Surgery (P.M.S., D.H.J.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
⁴ University of South Carolina School of Medicine (N.K.), Greenville, South Carolina.
⁵ Department of Radiology and Biomedical Imaging (X.W., C.M.G.), University of California, San Francisco, San Francisco, California.
⁶ Department of Otolaryngology-Head and Neck Surgery (I.H.E.), University of California, San Francisco, San Francisco, California.
⁷ Department of Radiology (A.F.J.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts amy_juliano@meei.harvard.edu.

PMID: 38360789
DOI: 10.3174/ajnr.A8146

Abstract

Background: Neoplasms derived from the sinonasal epithelium are a rare finding in the temporal bone, and their origins are controversial.

Purpose: To review the characteristics of sinonasal epithelial (previously known as Schneiderian) tumors occurring in the temporal bone.

Data source: This was a 2-center case series and systematic review of MEDLINE, EMBASE, and the Web of Science through May 2021.

Study selection: Patients with clinicopathologic evidence of temporal bone involvement by neoplasms of sinonasal epithelial origin were selected, with or without a history of prior primary sinonasal epithelial tumors.

Data analysis: Clinical, radiologic, and pathologic data were extracted.

Data synthesis: The systematic review included 56 studies and our 8 unpublished cases, totaling 76 cases of papillomas or squamous cell carcinomas in the temporal bone. Of these, 51% occurred secondary to sinonasal tumors, and 49% occurred primarily. Secondary tumors were usually metachronous (77%), with a median delay of 1 year from sinonasal-to-temporal bone tumor diagnosis. Most cases were unilateral (90%); bilateral temporal bone involvement occurred only as secondary ("trilateral") tumors. Unilateral secondary tumors had ipsilateral (81%) or bilateral (19%) sinonasal counterparts. Secondary tumors were more likely to be malignant (OR, 6.7, P < .001).

Limitations: The review was based on case reports and small case series, which are subject to reporting bias.

Conclusions: The observed tumor patterns support the hypothesis that the Eustachian tube facilitates the spread of sinonasal epithelium-derived neoplasms from the sinonasal cavity to the temporal bone. Transtubal spread of sinonasal epithelium-derived neoplasms should be considered among the rare causes of middle ear masses.