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Article

Meningeal Metastasis from Naso-Ethmoidal Malignancies: Pathogenesis, Risk Factors, and Prognostic Impact

by
Remo Accorona
1,†,
Isabelle Dohin
2,3,†,
Davide Mattavelli
2,3,*,
Marco Ferrari
4,
Marco Ravanelli
3,5,
Vittorio Rampinelli
2,
Davide Farina
3,5,
Piero Nicolai
4,
Cesare Piazza
2,3 and
Alberto Schreiber
2
1
Unit of Otorhinolaryngology, ASST Grande Ospedale Metropolitano Niguarda, 2062 Milan, Italy
2
Unit of Otorhinolaryngology—Head and Neck Surgery, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
3
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy
4
Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padova—Azienda Ospedale Università Padova, 35121 Padova, Italy
5
Radiology Unit, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Pers. Med. 2025, 15(2), 41; https://doi.org/10.3390/jpm15020041
Submission received: 1 October 2024 / Revised: 9 December 2024 / Accepted: 10 January 2025 / Published: 22 January 2025
(This article belongs to the Special Issue Sinonasal and Skull Base Pathologies: Personalized Management Based on Radiological and Biological Fingerprint)
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Abstract

Introduction: Meningeal metastasis (MM) from naso-ethmoidal malignancies (NEMs) is rare, its metastatic route is still debated, and its prognostic impact remains unclear. Our aim is to analyze a retrospective series of NEMs with non-contiguous MM to study the possible route of spread and the prognostic value of MM. Materials and methods: The institutional database of SNC treated at the University of Brescia between 1995 and 2021 was reviewed. Clinical–pathological data were collected, and survivals were estimated with Kaplan–Meier. Univariate and multivariate logistic regression analysis were run to identify predictors of MM. Results: Among 296 patients, 17 experienced non-contiguous MM, all located along the dura. Intestinal-type adenocarcinoma (10/17) and olfactory neuroblastoma (3/17) were the most frequent histologies. At univariate analysis, brain edema (p < 0.0001), resection (p = 0.026) or invasion (p = 0.006) of brain parenchyma, and local (p = 0.0004) and nodal (p = 0.021) recurrence were predictors of MM. At multivariate analysis, local recurrence was confirmed as an independent factor (odds ratio: 11.88, p = 0.0005). Dural surgical resection was not a risk factor. The five-year disease-specific survival was longer in patients with exclusive MM compared with patients with distant metastasis at other sites (64.3% vs. 30.1% p = 0.046). Conclusions: Dural venous shunt is the most likely pathway of spread of MM. Local recurrence is the only independent risk factor. Exclusive MM has a better prognosis than extrameningeal metastasis.
Keywords: meningeal metastases; dural metastases; sinonasal; cancer; recurrence meningeal metastases; dural metastases; sinonasal; cancer; recurrence

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MDPI and ACS Style

Accorona, R.; Dohin, I.; Mattavelli, D.; Ferrari, M.; Ravanelli, M.; Rampinelli, V.; Farina, D.; Nicolai, P.; Piazza, C.; Schreiber, A. Meningeal Metastasis from Naso-Ethmoidal Malignancies: Pathogenesis, Risk Factors, and Prognostic Impact. J. Pers. Med. 2025, 15, 41. https://doi.org/10.3390/jpm15020041

AMA Style

Accorona R, Dohin I, Mattavelli D, Ferrari M, Ravanelli M, Rampinelli V, Farina D, Nicolai P, Piazza C, Schreiber A. Meningeal Metastasis from Naso-Ethmoidal Malignancies: Pathogenesis, Risk Factors, and Prognostic Impact. Journal of Personalized Medicine. 2025; 15(2):41. https://doi.org/10.3390/jpm15020041

Chicago/Turabian Style

Accorona, Remo, Isabelle Dohin, Davide Mattavelli, Marco Ferrari, Marco Ravanelli, Vittorio Rampinelli, Davide Farina, Piero Nicolai, Cesare Piazza, and Alberto Schreiber. 2025. "Meningeal Metastasis from Naso-Ethmoidal Malignancies: Pathogenesis, Risk Factors, and Prognostic Impact" Journal of Personalized Medicine 15, no. 2: 41. https://doi.org/10.3390/jpm15020041

APA Style

Accorona, R., Dohin, I., Mattavelli, D., Ferrari, M., Ravanelli, M., Rampinelli, V., Farina, D., Nicolai, P., Piazza, C., & Schreiber, A. (2025). Meningeal Metastasis from Naso-Ethmoidal Malignancies: Pathogenesis, Risk Factors, and Prognostic Impact. Journal of Personalized Medicine, 15(2), 41. https://doi.org/10.3390/jpm15020041

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