Journal of Diagnostics Concepts & Practice >
Clinicopathological analysis and literature review of SMARCB1-deficient sinonasal carcinoma
Received date: 2024-12-26
Revised date: 2025-07-08
Accepted date: 2025-08-22
Online published: 2025-10-25
SMARCB1(SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily B, member 1)-deficient sinonasal carcinoma (SDSC) is a rare and highly aggressive malignant neoplasm of the head and neck region, accounting for 2.7% to 7.0% of primary sinonasal carcinomas. It exhibits a broad age distribution, non-specific clinical manifestations, and histomorphological features that closely mimic various other head and neck malignancies, posing significant diagnostic challenges for pathologists. This report details two SDSC cases treated in the Department of Patho-logy, Guangzhou First People's Hospital. Case 1 was a 75-year-old female who demonstrated combined loss of expression of SMARCB1 (Integrase Interactor 1, INI-1) and SMARCA2(SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 2) (Brahma Homolog, BRM) proteins. The tumors were mainly located in the right maxillary sinus and nasal cavity. Case 2 was a 60-year-old male who exhibited loss of SMARCB1 (INI-1) expression only. The tumors were located in the left posterior ethmoid sinus. Histologically, both cases were predominantly composed of basaloid cells, interspersed with a minor population of cells exhibiting plasmacytoid/rhabdoid morphology characterized by eccentric nuclei. Case 1 featured extensive geographic tumor necrosis, with only scant residual viable tumor tissue. The clinical stage of both cases was cT4NxM0 at the time of diagnosis. Follow-up: Case 1 received two cycles of induction chemotherapy combined with immunotherapy and died 3 months post-diagnosis. Case 2 underwent extended tumor resection followed by adjuvant therapy and died 12 months post-diagnosis. Comparative analysis revealed that the case with co-loss of SMARCB1 (INI-1) and SMARCA2 (BRM) expression was accompanied by more significant tumor necrosis morphologically and had a shorter survival time. According to literature and database searches worldwide, a total of 236 SDSC cases were reported, with an age range of 25-86 years and a male-to-female ratio of approximately 5:3 to 8:3. Among them, four cases (4/236) showed co-loss of SMARCB1 (INI-1) and SMARCA2 (BRM). However, there are still insufficient data to suggest that such cases have a worse survival prognosis. In conclusion, the overall prognosis of SDSC patients is poor, and there is currently no standard treatment plan. Morphological examination combined with SMARCB1 (INI-1) immunohistochemical testing is the key to definitive diagnosis, and combined detection of SWI/SNF complex member proteins helps identify co-loss cases. Although co-loss cases are rare and the significance of their survival prognosis analysis is unclear, more clinical experience is needed.
ZHENG Xiangyu , CHEN Jinxiang , LIU Guorong , YANG Yaoxiang , CAI Shaoting , YANG Jing . Clinicopathological analysis and literature review of SMARCB1-deficient sinonasal carcinoma[J]. Journal of Diagnostics Concepts & Practice, 2025 , 24(05) : 555 -561 . DOI: 10.16150/j.1671-2870.2025.05.012
| [1] | AGAIMY A, DIN N U, JAIN D, et al. SWI/SNF complex-deficient sinonasal carcinoma[M/OL]. WHO classification of tumours editorial board. Head and neck tumours. Lyon (France): International Agency for Research on Cancer. 5th ed. 2023[2024-11-01]. https://tumourclassification.iarc.who.int/chapters/52. |
| [2] | BISHOP J A, ANTONESCU C R, WESTRA W H. SMARCB1 (INI-1)-deficient carcinomas of the sinonasal tract[J]. Am J Surg Pathol, 2014, 38(9):1282-1289. |
| [3] | AGAIMY A, KOCH M, LELL M, et al. SMARCB1(INI1)-deficient sinonasal basaloid carcinoma: a novel member of the expanding family of SMARCB1-deficient neoplasms[J]. Am J Surg Pathol, 2014, 38(9):1274-1281. |
| [4] | 汤申隽, 翟长文, 袁存存, 等. SMARCB1(INI1)缺失的鼻腔鼻窦癌六例临床病理学特征[J]. 中华病理学杂志, 2020, 49(1):47-51. |
| TANG S J, ZHAI C W, YUAN C C, et al. SMARCB1 (INI1)-deficient sinonasal carcinoma: a clinicopathological analysis of six cases[J]. Chin J Pathol, 2020, 49(1):47-51. | |
| [5] | LEE V H, TSANG R K, LO A W I, et al. SMARCB1 (INI-1)-deficient sinonasal carcinoma: A systematic review and pooled analysis of treatment outcomes[J]. Cancers (Basel), 2022, 14(13): 3285. |
| [6] | AGAIMY A, HARTMANN A, ANTONESCU C R, et al. SMARCB1 (INI-1)-deficient sinonasal carcinoma: A series of 39 cases expanding the morphologic and clinicopathologic spectrum of a recently described entity[J]. Am J Surg Pathol, 2017, 41(4):458-471. |
| [7] | SKáLOVá A, TAHERI T, BRADOVá M, et al. SMARCB1-deficient sinonasal adenocarcinoma: a rare variant of SWI/SNF-deficient malignancy often misclassified as high-grade non-intestinal-type sinonasal adenocarcinoma or myoepithelial carcinoma[J]. Virchows Arch, 2024, 485(2):245-256. |
| [8] | NG J K M, CHAN J Y K, LI J J X, et al. SMARCB1 (INI1)-deficient sinonasal carcinoma with yolk sac differentiation showing Co-loss of SMARCA4 immunostaining - a case report and literature review[J]. Head Neck Pathol, 2022, 16(3):934-941. |
| [9] | 刘驯骅, 刘艳辉, 李智, 等. INI1缺失性鼻腔鼻窦癌9例临床病理分析[J]. 临床与实验病理学杂志, 2023, 39(3):326-330. |
| LIU X H, LIU Y H, LI Z, et al. INI1-deficient sinonasal carcinoma:clinicopathologic analysis of 9 cases and review of literatures[J]. Clin Exp Pathol, 202339(3):326-330. | |
| [10] | KAKKAR A, ANTONY V M, PRAMANIK R, et al. SMARCB1 (INI1)-deficient sinonasal carcinoma: a series of 13 cases with assessment of histologic patterns[J]. Hum Pathol, 2019, 83:59-67. |
| [11] | DERMAWAN J K, SINGER S, TAP W D, et al. The genetic landscape of SMARCB1 alterations in SMARCB1-deficient spectrum of mesenchymal neoplasms[J]. Mod Pathol, 2022, 35(12):1900-1909. |
| [12] | LI Q, ABI-SAAB T, PRILUTSKIY A, et al. Clinicopathologic and molecular characterization of SMARCB1-deificient sinonasal carcinomas -a systematic study from a single institution cohort[J]. Head Neck Pathol, 2025, 19(1):60. |
| [13] | BANECKOVA M, COX D. Top 10 basaloid neoplasms of the sinonasal tract[J]. Head Neck Pathol, 2023, 17(1):16-32. |
| [14] | XU B, KATABI N. Myoepithelial Carcinoma[J]. Surg Pathol Clin, 2021, 14(1):67-73. |
| [15] | SIDERIS G, SOLOMOS P, GOGOULOS P, et al. Neuroendocrine and undifferentiated sinonasal and skull base tumors: An up-to-date narrative review[J]. Oral Maxillofac Surg, 2024, 28(3):1009-1017. |
| [16] | METE O, WENIG B M. Update from the 5th edition of the World Health Organization classification of head and neck tumors: Overview of the 2022 WHO classification of head and neck neuroendocrine neoplasms[J]. Head Neck Pathol, 2022, 16(1):123-142. |
| [17] | MORENO V, SALUJA K, PINA-OVIEDO S. NUT carcinoma: Clinicopathologic features, molecular genetics and epigenetics[J]. Front Oncol, 2022, 12:860830. |
| [18] | 张蕊仙, 皇甫辉, 高泽慧. SMARCB1(INI-1)缺失性鼻腔鼻窦癌的诊疗进展[J]. 中国耳鼻咽喉颅底外科杂志, 2023, 29(3):115-120. |
| ZHANG R X, HUANG F H, GAO Z H. Progress in the diagnosis and treatment of patients with SMARCB1 ( INI-1) -deficient sinonasal carcinoma[J]. Chin J Otorhinolaryngol Skull Base Surg, 2023, 29(3):115-120. | |
| [19] | SHAVERDASHVILI K, AZIMI-NEKOO E, COHEN P, et al. INI-1 (SMARCB1)-deficient undifferentiated sinonasal carcinoma: Novel paradigm of molecular testing in the diagnosis and management of sinonasal malignancies[J]. Oncologist, 2020, 25(9):738-744. |
| [20] | WANG T, WANG J, TANG T, et al. Treatment for SMARCB1 (INI-1) deficient sinonasal tumor: a single-institution study[J]. Neoplasma, 2023, 70(6):804-810. |
| [21] | 王灵娃, 王茹, 房居高, 等. SMARCB1/INI-1缺失性鼻腔鼻窦癌的临床诊治分析[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(7):848-853. |
| WANG L W, WANG R, FANG J G, et al. Analysis of the diagnosis and treatment of patients with SMARCB1 (INI-1)-deficient sinonasal carcinoma[J]. Chin J Otorhinolaryngol Head Neck Surg, 2022, 57(7):848-853. |
/
| 〈 |
|
〉 |