Abstract
The sinonasal tract is an environment diverse with neoplasia. Given the continued discovery of entities generally specific to the sinonasal tract, the fourth edition of the World Health Organization Classification of Head and Neck Tumors was released in 2017. It describes 3 new, well-defined entities and several less-defined, emerging entities. The new entities are seromucinous hamartomas, nuclear protein in testis carcinomas, and biphenotypic sinonasal sarcomas. Emerging entities include human papillomavirus-related sinonasal carcinomas, SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1-deficient sinonasal carcinomas, renal cell-like adenocarcinomas, and chondromesenchymal hamartomas. The literature thus far largely focuses on the pathology of these entities. Our goal in this report was to familiarize radiologists with these new diagnoses and to provide available information regarding their imaging appearances.
Highlights
NEW ENTITIES Seromucinous HamartomaAdenosis.[16] Both lesions affect adults with a male predilection, 7:1 for respiratory epithelial adenomatoid hamartoma (REAH) and 5:2 for seromucinous hamartoma (SH)
ABBREVIATIONS: Human papillomavirus (HPV) ϭ human papillomavirus; NUT ϭ nuclear protein in testis; Nuclear protein in testis midline carcinomas (NMCs) ϭ nuclear protein in testis midline carcinomas; squamous cell carcinomas (SCCs) ϭ squamous cell carcinoma; SH ϭ seromucinous hamartoma; SWI/SNF ϭ SWItch/Sucrose Non-Fermentable; SMARCB1 ϭ SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1; SNUC ϭ sinonasal undifferentiated carcinoma; REAH ϭ respiratory epithelial adenomatoid hamartoma; World Health Organization (WHO) ϭ World Healt
REAHs have been described in isolation and in the setting of concomitant sinonasal disease from inflammatory polyposis to malignancy, an association that suggests a potential reactive etiology of these lesions.[18,19]
Summary
Adenosis.[16] Both lesions affect adults with a male predilection, 7:1 for REAH and 5:2 for SH Presenting symptoms for both include nasal congestion, anosmia, and rhinorrhea.[15,17] REAHs have been described in isolation and in the setting of concomitant sinonasal disease from inflammatory polyposis to malignancy, an association that suggests a potential reactive etiology of these lesions.[18,19] Recurrence of REAHs and SHs after resection is rare.[16]. The olfactory cleft is often expanded and smoothly remodeled without erosive changes.[18] REAHs are heterogeneous on T2WI and isointense on T1WI relative to the cortex and enhance uniformly (Fig 1).[21] To our knowledge, no substantial dedicated literature regarding the appearance of SHs on imaging exists to date. “crescent sign” morphology on sagittal images, in our experience, is suggestive of REAH and SH within the olfactory cleft
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