Page 48 - Portuguese Journal - SPORL - Vol 61. Nº2

Table 5 and subsequent invasion of pterygopalatine
Histologic classification according to the 4th fossa and osteoneogenis, in probable relation
edition of World Health Organization (WHO)
classification of tumors with inverted papilloma.
Surgical treatment was the preferred primary
Number of modality of treatment (16 patients, 84.2%).
Site of origin
patients (%) Nine patients (56.3%) were submitted to
Epithelial malignancies 11 (57.9%) external approach, while 7 patients (43.8%)
Squamous cell carcinoma 4 (21.1%) underwent endonasal endoscopic treatment.
In table 6 is summarized the histology and
Adenocarcinoma 3 (15.8%)
local staging for patients that underwent
Adenoid cystic carcinoma 3 (15.8%)
surgical treatment as the initial treatment.
Neuroendocrine tumors 1 (5.3%) Pathologic analysis revealed microscopic
Soft tissue malignancies 3 (15.8%) positive margins in 8 patients (50%), negative
Angiosarcoma 1 (5.3%) margins in 6 patients (37.5%) and not
evaluable in 2 patients (12.5). Neck dissection
Leiomyosarcoma 1 (5.3%)
was performed in 2 patients (12.5%) with N1
Rhabdomyosarcoma 1 (5.3%)
disease, one with squamous cell carcinoma
Neuroectodermal and the other with mucosal malignant
malignancies 5 (26.3%)
melanoma. In patients submitted to primary
Mucosal malignant surgical treatment, adjuvant radiotherapy was
melanoma 3 (15.8%)
performed in 10 patients, whereas adjuvant
Olfactory neuroblastoma 2 (10.5%) chemoradiotherapy in 2 patients. Non-surgical
treatment was the treatment of choice in 3
a squamous cell carcinoma and the last was patients (15.8%). In this subgroup, 1 patient
referred after an incidental diagnosis in a CT received radiotherapy, 1 chemoradiotherapy
scan of the head revealing an expansive mass and 1 chemotherapy (table 7). Mean follow-
in the left maxillary sinus with bone erosion up period of patients was 26.9 ± 20.6 months

Table 6
Histology and local staging for patients submitted to surgery as initial treatment

Histology Local staging (TN)
External approach (n=9)
Leiomyosarcoma (n=1) Not applicable
Squamous cell carcinoma (n=2) T1N0; T4aN1
Adenocarcinoma (n=1) T3N0
Neuroendocrine tumors (n=1) T4bN0
Adenoid cystic carcinoma (n=2) T3N0; T4bN0
Angiosarcoma (n=1) Not applicable
Olfactory neuroblastoma (n=1) Not applicable
Endonasal approach (n=7)

Squamous cell carcinoma (n=1) T4aN0
Adenocarcinoma (n=2) T3N0; T1N0
Adenoid cystic carcinoma (n=1) T1N0
Olfactory neuroblastoma (n=1) Not applicable
Mucosal malignant melanoma (n=2) T3N0; T3N1

190 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery