Characterization of initial clinical symptoms and risk factors for sinonasal adenocarcinomas: Results of a case-control study
Sinonasal adenocarcinoma is a rare cancer, frequently associated with occupational exposure to inhalable wood dust. Among the EU member States, Germany was reported to have the highest number of exposed workers. Location and long latency make early diagnosis difficult. This case-control study was aimed at assessing potential risk factors and at characterizing initial clinical symptoms, both serving as matrix to identify persons at increased risk and to improve management of this cancer.
Of 58 patients, 31 diagnosed with sinonasal adenocarcinoma (cases) between 1973 and 2007 were identified and underwent standardized interview on clinical data. A total of 85 patients diagnosed over the same period with carcinoma of the oral cavity served as controls.
The ethmoid was confirmed as the predominant site of adenocarcinoma associated with wood dust exposure, whereas the nasal cavity was most commonly affected in patients denying any exposure to wood dust. Cases were significantly engaged in mainly woodworking occupations compared to controls. The main initial clinical symptoms were nasal obstruction 6 months (71%) and epistaxis 4 years (41.9%) prior to diagnosis. Hardwood dust from beech and oak proved to be the most common occupational exposure, with a mean exposure period of 32.3 years and a latency of 43.5 (34-58) years.
Our investigation confirms the importance of regular screenings for persons exposed to wood dust even years after the end of occupational or private exposure. Banal clinical symptoms such as epistaxis and nasal obstruction might be predictive, requiring early and thorough investigation.
Available from: Giuseppina Improta
- "Carcinomas of the sinonasal tract are highly aggressive neoplasm arising from the nasal cavity and paranasal sinus. Although sinonasal carcinoma is rare, it must be suspected when facing with an ulcerated mucosa of this tract even in young patients . Clinical presentation is usually that of epistaxis, nasal obstruction, nasal discharge with occasional bloody drainage, and serious otitis media which may be among the earliest symptoms. "
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ABSTRACT: We report a case of Wegener's granulomatosis clinically mistaken for carcinoma in a 21-year-old girl presenting with an ulcerated mass of the nasopharynx associated with enlarged laterocervical nodes. The lesion was clinically suspected as malignant on the basis of clinical and radiological findings (namely, computed tomography scan and positron emission tomography). However, multiple biopsies were not conclusive for malignancy showing histological change suggestive of Wegener's granulomatosis. A serum determination of cANCA supported the diagnosis of Wegener's granulomatosis. Clinical findings and image studies suggested an erroneous diagnosis of malignancy whereas a definitive diagnosis of Wegener's granulomatosis was achieved only after repeated biopsies thus leading to a correct therapeutic approach. The Wegener granulomatosis must be added to the list of the differential diagnoses of the masses of the nasopharynx associated with or without enlarged laterocervical nodes.
09/2013; 2013(9):839451. DOI:10.1155/2013/839451
Available from: sciencedirect.com
- "Author, place, date n (m/f) Age (years) Wood-dust exposure (%) T grade (%) 5-yr survival (%) Recurrence (%) T1 T2 T3 T4 De Gabory, Bordeaux  2010 87/8 64 73 2 22 37 39 78 31 Mayr, Erlangen  2009 31 − 32 − − − − − − Choussy, GETTEC study  2008 418 63 28 3 32 23 42 64 51 Liétin, Clermont-Ferrand  2005 59/1 62 26 − − − − 47 − Jegoux, Nantes  2004 78/2 63 67 5 23 31 41 63 44 Michel, Amiens  2003 10 − − − − − − 53 60 Guillotte, Reims  2003 17 − − 0 12 0 88 41 58 Claus, Bruges  2002 47 − 81 4 36 23 36 60 − Dulguerov, Los Angeles  2001 25 − − − − − − 63 − Choussy, Rouen  2001 19 57 − 0 37 50 13 69 − Stoll, Bordeaux  2001 71/5 61 26 3 18 58 20 80 23 Breheret, Angers 2010 41/1 61 85 12 31 9 48 44.2 46 "
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ABSTRACT: Retrospective analysis of the oncological results and morbidity of ethmoid sinus adenocarcinoma surgery, and identification of survival factors.
Forty-two patients were treated from 1990 to 2009. The study covered clinical presentation, medical imaging, histologic data, TNM grade, treatment, morbidity and overall recurrence-free survival.
Forty-one men and one woman, with mean age at diagnosis of 61.5 years, were included. 85.7% had been exposed to wood dust. Twenty patients (47.6%) were graded T4 at diagnosis. Thirty-three (78.5%) were treated by surgery followed by radiation therapy; nearly half of these showed recurrence. Overall specific 5-year survival was 44.2% at 5 years and recurrence-free 5-year survival 46.4%. The factors of poor prognosis found were cerebromeningeal or orbital invasion and local recurrence.
This series confirms the epidemiological literature on ethmoid adenocarcinoma and the influence of poor prognosis factors. Survival depended directly on local tumor control and seemed to be enhanced on an isolated transfacial approach.
European Annals of Otorhinolaryngology, Head and Neck Diseases 05/2011; 128(5):211-7. DOI:10.1016/j.anorl.2011.02.012 · 0.82 Impact Factor
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ABSTRACT: This paper considers the resource allocation problem in space-division multiple access (SDMA)/multi-input-single-output (MISO)/OFDM systems. Our objective function is to maximize the total system data rate subject to total power constraint and each user's quality-of-service (QoS) requirement. In this SDMA/MISO/OFDM multiuser system, each user possesses a spatial filter in each subcarrier to remove interference from other users in that subcarrier. We observe that the number of users in a subcarrier has two conflicting effects on the system throughput. Adding more users in a subcarrier increases the number of spatial channels; however, at the same time, it introduces more interference among the users which reduces the throughput in each spatial channel. This paper takes into consideration these effects to solve the rate maximization problem.
Communications, 2004 IEEE International Conference on; 07/2004
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