Sinonasal Papillomas and Carcinomas: A Contemporary Update With Review of an Emerging Molecular Classification

Abstract

Context.— Sinonasal papillomas and carcinomas are uncommon head and neck neoplasms that comprise a broad clinicopathologic and morphologic spectrum, and thus frequently represent a diagnostic challenge for surgical pathologists. Recent molecular interrogation of these tumors has delineated a number of recurrent alterations that correspond to distinct entities with potential diagnostic and/or therapeutic clinical utility. Objective.— To summarize the salient clinicopathologic, morphologic, and molecular features of sinonasal papillomas and carcinomas. Data Sources.— Review of pertinent literature regarding sinonasal papillomas and sinonasal carcinomas. Conclusions.— Despite their relative rarity in many surgical pathology practices, sinonasal papillomas and carcinomas frequently demonstrate characteristic morphologic features that are important for accurate diagnosis. Given our emerging understanding of the molecular basis for these tumors, judicious use of available ancillary tools—including immunohistochemistry and in situ hybridization—may be helpful in subsets of cases, whereas additional molecular testing may be useful for diagnostically challenging and/or clinically aggressive sinonasal tumors.