Sinonasal and laryngeal carcinoma in children: correlation of imaging characteristics with clinicopathologic and cytogenetic features.
OBJECTIVE
Pediatric upper airway carcinoma is uncommon, symptoms are nonspecific, and diagnosis is often delayed. In this study, we describe the imaging, cytogenetics, and clinical courses of 4 patients with pediatric upper airway carcinoma.


METHODS
Four patients with upper airway carcinoma were identified during a 2.5-year period. CT (n = 4) and MR imaging (n = 3) studies, tumor histopathologic features and cytogenetics, patient treatment, and clinical course were reviewed.


RESULTS
Patients were aged 12 to 15 years. One tumor involved the larynx with poorly defined margins and heterogeneous enhancement; 1 heterogeneously enhancing tumor involved the epiglottis with necrotic cervical lymphadenopathy. There were 2 enhancing sinonasal tumors with bony destruction in 1 tumor. Tumors had a relatively short relaxation time on FSEIR MR imaging. Histopathologic examination revealed poorly differentiated squamous cell carcinoma (n = 3) and well-differentiated squamous cell carcinoma (n = 1). Cytogenetic analysis revealed chromosomal abnormalities in 3 tumors: 2 showed a chromosomal translocation t(15;19), and 1 showed a chromosomal translocation t(1;5) and loss of a portion of chromosome 22q. Results of in situ hybridization for EBV were negative (n = 3). Treatment included tumor resection (n = 2), chemotherapy (n = 4), and radiation therapy (n = 3). Patients with t(15;19) died months after diagnosis. Two patients were alive at 8-year follow-up.


CONCLUSIONS
Childhood carcinoma of the upper airway is uncommon but should be considered in the diagnosis of upper airway tumors that display aggressive imaging characteristics. Carcinoma with t(15;19) is rare but has been reported, usually in young patients with midline carcinoma of the neck or mediastinum, with a rapidly fatal course.
Department of Radiology, Neuroradiology Division, Children's Hospital, Boston, Massachusetts 02115, USA. caroline.robson@tch.harvard.edu
C D
CD
Robson
R
R
Rahbar
S O
SO
Vargas
K J
KJ
Marcus
J W
JW
Mack
G R
GR
Licameli
H E
HE
Grier
D000293:Adolescent; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology; D002648:Child; D002884:Chromosomes, Human, Pair 15; D002888:Chromosomes, Human, Pair 19; D004825:Epiglottis / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005931:Glottis / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009669:Nose Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014178:Translocation, Genetic