Sinonasal adenoid cystic carcinoma: Treatment outcomes and association with human papillomavirus

Abstract

Background: The purpose of this study was to review long-term outcomes of sinonasal adenoid cystic carcinoma (ACC) and to clarify its association with human papillomavirus (HPV).

Methods: The medical records of 23 patients with sinonasal ACC treated with primary surgical resection between 1998 and 2013 were reviewed. Tissue specimens were available for 17 patients. The p16 testing was performed using immunohistochemistry (IHC), and HPV infection was determined using quantitative polymerase chain reaction (PCR) with primers targeting the E6/E7 region.

Results: Two of the 17 samples showed strong and diffuse p16 staining, whereas the remaining 15 cases showed p16-positivity isolated to the luminal cells. Only one of the p16-positive cases was positive for HPV. The 5-year local failure, disease-free survival (DFS), and overall survival (OS) were 51%, 52%, and 62%, respectively.

Conclusion: Local failures are common with advanced sinonasal ACC, and the association of HPV with true sinonasal ACC is low.

Keywords: adenoid cystic carcinoma; human papillomavirus; p16; paranasal sinus neoplasms; radiotherapy.

Figure 1

Kaplan-Meier curves for entire patient cohort including local failure (LF), disease-free survival (DFS), and overall survival (OS).

Figure 2

Hematoxylin and eosin and p16 immunohistochemistry staining of a p16 negative (panels A, B) and a p16 positive (panels C, D) sinonasal adenoid cystic carcinoma case. Note, the case shown in C, D was also positive for HPV 33. All magnifications x 20.