Nasal cavity, paranasal sinuses, nasopharynx
Sinonasal carcinoma
General

Author: Abul Ala Syed Rifat Mannan, M.D. (see Authors page)
Editor: Songyang Yuan, M.D., Ph.D.

Revised: 21 May 2018, last major update September 2013

Copyright: (c) 2004-2018, PathologyOutlines.com, Inc.

PubMed Search: Sinonasal carcinoma[TIAB]

Cite this page: Mannan, A.A.S.R. Sinonasal carcinoma - general. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/nasalcarcinomageneral.html. Accessed October 17th, 2018.
Definition / general
  • Rare and heterogenous malignancy of sinonasal tract
Epidemiology
Sites
  • Usually maxillary sinus, 20% in ethmoid sinuses
  • < 1% originate in frontal and sphenoid sinuses
Etiology
Clinical features
  • Usually nonspecific, often mimics benign diseases
  • Nasal obstruction, rhinorrhea, headache, facial pressure, hyposmia
  • 9 - 12% of patients with sinonasal malignancies are asymptomatic (Ear Nose Throat J 2001;80:272) - delayed diagnosis is common
  • 75% of paranasal sinus tumors are stage T3 or T4 at diagnosis (Otolaryngol Clin North Am 2004;37:473)
Diagnosis
  • Low threshold for radiologic investigation is important due to nonspecific nature of symptoms
  • CT / MRI helpful in delineating nature / extent of disease
  • Biopsy is useful for histologic confirmation
Prognostic factors
  • Tumor stage is most important prognostic variable
  • Bony destruction and invasion of adjacent head and neck structures are associated with poor prognosis
  • Cranial nerve involvement portends poor outcome
Treatment
  • Most Stage T1 or T2 maxillary sinus carcinomas are treated by surgery alone, with adequate resection margins
  • T3 and T4 lesions are treated by combination therapy with surgery and radiation
Microscopic (histologic) description
  • 75 - 90% are squamous cell carcinoma (Head Neck 2002;24:821)
  • Other subtypes include sinonasal adenocarcinoma (intestinal and nonintestinal subtypes), adenoid cystic carcinoma, sinonasal undifferentiated carcinoma
Microscopic (histologic) images

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Contributed by Dr. Eman Abdelzaher, Alexandria University (Egypt):

Various images