title: Management of sinonasal undifferentiated carcinoma with intracerebral invasion: Clinical experience at a single institution and review of the literature.
abstract: Sinonasal undifferentiated carcinoma (SNUC) represents less than 1% of all malignancies. Most of the tumors are diagnosed at an advanced stage, when they have already invaded neighboring tissue structures. We describe the cases of 2 patients with a substantial intracerebral extension of SNUC who were treated at our institution. One was treated with surgery followed by chemoradiotherapy. The other was primarily treated with induction chemotherapy with a combination of docetaxel, cisplatin, and 5-fluorouracil followed by concurrent chemo- and radiotherapy. In view of the rarity of SNUC, no prospective clinical trials have been performed and a gold standard for treatment has not yet been established. Therefore, treatment recommendations are based on level IV evidence. These recommendations are diverse and controversial. In our 2 cases, the patient who was treated with induction chemotherapy had a better outcome. In cases of intracerebral extension, radical surgery is necessary and induction chemotherapy should be considered.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Krankenhaus Rudolfstiftung, Juchgasse 25, 1030 Vienna, Austria. valeriezielinski@me.com.
authors.forename: Valerie
authors.initials: V
authors.lastname: Zielinski
authors.forename: Simon
authors.initials: S
authors.lastname: Laban
authors.forename: Silke
authors.initials: S
authors.lastname: Tribius
authors.forename: Phillipe
authors.initials: P
authors.lastname: Schafhausen
authors.forename: Simon
authors.initials: S
authors.lastname: Veldhoen
authors.forename: Rainald
authors.initials: R
authors.lastname: Knecht
authors.forename: Till
authors.initials: T
authors.lastname: Clauditz
authors.forename: Adrian
authors.initials: A
authors.lastname: Muenscher
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D060828:Induction Chemotherapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D009361:Neoplasm Invasiveness; D013517:Otorhinolaryngologic Surgical Procedures; D043823:Taxoids / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil