Abstract

The sinonasal cavities harbour a variety of rare tumour types. Many carry a poor prognosis while therapeutic options are limited. Histopathological classification can be difficult, especially for poorly differentiated tumours such as olfactory neuroblastoma (ONB), sinonasal neuroendocrine carcinoma (SNEC) and sinonasal undifferentiated carcinoma (SNUC). We analysed Affymetrix OncoScan genome-wide copy number profiles of these three tumour types, both as originally diagnosed and as regrouped by their cytokeratin (Ck) and neuroendocrine (Ne) expression pattern, aiming to find a relation between phenotype and genotype. According to the original histopathological classification our series consisted of 24 ONB, 11 SNEC and 19 SNUC, while immunohistochemistry indicated 11 Ck−Ne+/ONB, 18 Ck+Ne+/SNEC, 24 Ck+Ne−/SNUC, and 1 Ck−Ne−/unclassified. As originally diagnosed, the three tumour types showed similar copy number profiles. However, when regrouped by Ck/Ne immunostaining we found a distinct set of gains and losses; Ck−Ne+/ONB harboured few and predominantly whole chromosomes abnormalities, Ck+Ne+/SNEC carried both gains and losses in high frequency, and Ck+Ne−/SNUC showed mostly gains. In addition, each tumour carried a number of unique chromosomal deletions. Genome-wide copy number profiling supports the value of immunohistochemical CkNe staining of ONB, SNEC and SNUC for tumour classification, which is important for prognosis and therapeutic decision-making.

Highlights

  • The sinonasal cavities are an anatomical area from which emerges a wide histological diversity of neoplasms[1]

  • Ck+Ne+/sinonasal neuroendocrine carcinoma (SNEC) staining was observed in 18 cases, of which 9 had orginally been evaluated as olfactory neuroblastoma (ONB), 8 as SNEC and 1 as sinonasal undifferentiated carcinoma (SNUC)

  • A Ck+Ne−/ SNUC profile was seen in 24 cases, and of these, 4 had orginally been classified as ONB, 2 as SNEC and 18 as SNUC

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Summary

Introduction

The sinonasal cavities are an anatomical area from which emerges a wide histological diversity of neoplasms[1]. Diagnosis based primarily on morphological and histological features is a challenge for the pathologist, especially for those tumours with poor differentiation such as olfactory neuroblastoma (ONB), sinonasal neuroendocrine carcinoma (SNEC) and sinonasal undifferentiated carcinoma (SNUC). As these tumours have an incidence of approximately 1/100.000 inhabitants, it is hard to acquire sufficient experience. In a study of 23 head and neck neuroendocrine carcinomas including 11 cases occurring in the sinonasal cavities (i.e. SNEC), the 5-year overall survival was 91.5% for well and moderately differentiated tumours, dropping to 21.1% for poorly differentiated cases[13]. Lymph node or distant metastasis are relatively rare, occurring in approximately 10–20% of cases[1,2,8]

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