title: Primary Ewing's sarcoma of the sinonasal tract in adults: A challenging disease.
abstract: Sinonasal localization of Ewing's sarcoma in adults is an exceedingly rare event.
  
  
  
  The clinical records of 5 patients with primary sinonasal Ewing's sarcoma treated from 1992 to 2012 were retrospectively analyzed. All pathologic slides were reviewed by 2 experienced pathologists. All patients underwent multimodality treatments.
  
  
  
  Median age was 36 years (range, 25-52 years). At referral, 2 patients had the original diagnosis changed by review of the histologic slides. Tumors were classified as T4aN0M0 (4 patients) and T2N0M0 (1 patient). Median follow-up was 110 months (range, 70-139 months). Only 1 patient, who started treatment elsewhere based on an incorrect histologic diagnosis, experienced multiple recurrences and eventually died of widespread metastasis.
  
  
  
  Correct pathologic diagnosis can have a crucial impact on treatment planning and outcome. Multimodality therapy is the key for long-term successful results. Because of the rarity of the tumor, referral to highly experienced care centers is strongly recommended. © 2016 Wiley Periodicals, Inc. Head Neck 39: E45-E50, 2017.
authors.affiliation: Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Lombardi
authors.affiliation: Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Mattavelli
authors.affiliation: Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
authors.forename: Luca O
authors.initials: LO
authors.lastname: Redaelli De Zinis
authors.affiliation: Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
authors.forename: Remo
authors.initials: R
authors.lastname: Accorona
authors.affiliation: Unit of Pathology, Department of Translational and Molecular Medicine, University of Brescia, Brescia, Italy.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Morassi
authors.affiliation: Unit of Pathology, Department of Translational and Molecular Medicine, University of Brescia, Brescia, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Facchetti
authors.affiliation: Unit of Medical Oncology, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Ferrari
authors.affiliation: Unit of Radiology, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Farina
authors.affiliation: Adult Mesenchymal Tumor Medical Oncology Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Bertulli
authors.affiliation: Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012494:Sampling Studies; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Ewing's sarcoma; chemotherapy; multimodality treatment; sinonasal cancer; transnasal endoscopic surgery