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Sinonasal (Schneiderian) Tumors in the Temporal Bone: Case Series and Systematic Review
Francis Deng1, Peter M Sadow2,3, Nabeeha Khan4
1From the Russell H. Morgan Department of Radiology and Radiological Science (F.D.), Johns Hopkins University, Baltimore, Maryland.
Background:
Neoplasms derived from the sinonasal epithelium are a rare finding in the temporal bone, and their origins are controversial.
Purpose:
To review the characteristics of sinonasal epithelial (previously known as Schneiderian) tumors occurring in the temporal bone.
Data Source:
This was a 2-center case series and systematic review of MEDLINE, EMBASE, and the Web of Science through May 2021.
Study Selection:
Patients with clinicopathologic evidence of temporal bone involvement by neoplasms of sinonasal epithelial origin were selected, with or without a history of prior primary sinonasal epithelial tumors.
Data Analysis:
Clinical, radiologic, and pathologic data were extracted.
Data Synthesis:
The systematic review included 56 studies and our 8 unpublished cases, totaling 76 cases of papillomas or squamous cell carcinomas in the temporal bone. Of these, 51% occurred secondary to sinonasal tumors, and 49% occurred primarily. Secondary tumors were usually metachronous (77%), with a median delay of 1 year from sinonasal-to-temporal bone tumor diagnosis. Most cases were unilateral (90%); bilateral temporal bone involvement occurred only as secondary ("trilateral") tumors. Unilateral secondary tumors had ipsilateral (81%) or bilateral (19%) sinonasal counterparts. Secondary tumors were more likely to be malignant (OR, 6.7, P < .001).
Limitations:
The review was based on case reports and small case series, which are subject to reporting bias.
Conclusions:
The observed tumor patterns support the hypothesis that the Eustachian tube facilitates the spread of sinonasal epithelium-derived neoplasms from the sinonasal cavity to the temporal bone. Transtubal spread of sinonasal epithelium-derived neoplasms should be considered among the rare causes of middle ear masses.
