Intestinal Type Sinonasal Adenocarcinoma: A Clinicopathological Study of 48 Patients With Review of Literature.

Background: Intestinal type sinonasal adenocarcinoma is a gland forming malignant tumor of sinonasal tract which is histologically and immunohistochemically similar to intestinal type adenocarcinomas. Intestinal type sinonasal adenocarcinoma has a well-recognized etiological association with occupational exposure to wood dusts.

Objective: To report the clinicopathological factors of intestinal type sinonasal adenocarcinoma and review the published literature.

Methods: Forty-eight tumors reported as intestinal type sinonasal adenocarcinoma were retrieved and clinicopathological features were noted.

Results: Age ranged from 22 to 79 (mean 44) years with 36 men and 12 women. Most patients were presented with nasal blockage and difficulty in breathing. Occupational exposure to dust was present in the majority of patients. Tumors were composed of papillae or acini lined by dysplastic intestinal type columnar epithelium with interspersed goblet cells. There were 13 well differentiated (low grade) and 35 poorly differentiated (high-grade) tumors. CDX2 and SATB2 were expressed by the tumor cells in most tumors. Follow-up was available in 24 patients (range 3 months to 10 years). Most of the patients received chemo and/or radiotherapy. Metastases occurred in 19 out of 24 patients. Brain metastases were very common. All patients with metastases died of their disease.

Conclusion: Clinical and morphological features in our series were similar to published studies. It is important for pathologists to remember the association of these tumors with occupational exposure to wood dusts and to exclude metastases of intestinal adenocarcinomas when confronted by these tumors in the sinonasal tract.