J Neurol Surg B Skull Base 2018; 79(03): 282-288
DOI: 10.1055/s-0037-1607288
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Rates and Locations of Regional Metastases in Sinonasal Malignancies: The Mayo Clinic Experience

Brandon W. Peck
1   Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States
Kathryn M. Van Abel
1   Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States
Eric J. Moore
1   Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States
Daniel L. Price
1   Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations
Further Information

Publication History

28 February 2017

04 September 2017

Publication Date:
01 November 2017 (online)


Objectives The objective of this study was to identify factors that may influence the rate and location of regional metastasis in sinonasal malignancies (SNMs).

Design This is a retrospective review.

Setting This study was set at the single-institution tertiary referral center.

Participants A total of 299 patients were treated for SNMs from 1994 to 2014.

Main Outcome Measures The main outcome measures were incidence and distribution of regional metastases.

Results Several histologic subtypes were treated, with squamous cell carcinoma (28.4%), esthesioneuroblastoma (18.1%), and mucosal melanoma (12.4%) being the most common. Of the 299 patients, 59 (19.7%) developed a regional metastasis, either at presentation or during follow-up. Higher cumulative incidence of regional metastases was significantly associated with histologic type (p ≤0.001) and invasion of the dura (p = 0.005), infratemporal fossa (p = 0.036), orbit (p = 0.020), or palate (p = 0.016). Ipsilateral level II lymph nodes were the most commonly involved nodes. Contralateral regional metastases were associated with higher risk histologic types (p = 0.005) and dural invasion (p = 0.008). Parotid metastases were associated with invasion of the facial soft tissue (p = 0.028), and retropharyngeal metastases were associated with invasion of the pterygoid plates and musculature (p = 0.030).

Conclusion Histologic type of SNM appears to be the most important factor in predicting the rate of regional metastases. Histologic type and invasion of certain neighboring structures may help define which lymphatic basins are at highest risk for metastasis.

Level of Evidence

The level of evidence is Level IV—retrospective case series.

Financial Support

This research was supported by departmental funding.

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