Nasal cavity, paranasal sinuses, nasopharynx
Sinonasal carcinoma
Squamous cell carcinoma

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 December 2013

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

PubMed Search: Squamous cell carcinoma[TI] sinonasal

Cite this page: Mannan, A.A.S.R. Squamous cell carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/nasalscc.html. Accessed October 17th, 2018.
Definition / general
  • Epithelial malignancy originating from sinonasal surface epithelium
Terminology
  • Two broad histologic subtypes: keratinizing and nonkeratinizing
Epidemiology
  • ~3% of malignancies of head and neck; < 1% of malignant neoplasms at all sites
  • Most common malignant epithelial neoplasm of sinonasal tract
  • More common in Japan than in the West
  • More common in adult men
  • Average age at presentation is 55 - 65 years
  • Rare in patients < 40 years old
Sites
  • Maxillary sinus (60 - 70%), nasal cavity (12 - 25%), ethmoid sinus (10 - 15%), ethmoid and frontal sinuses (1%)
Etiology
Clinical features
  • Nasal fullness, epistaxis, rhinorrhea, pain, nasal / facial swelling are common presentations
  • Advanced cases may present with proptosis, diplopia or lacrimation
Prognostic factors
  • Patients with nasal tumors usually present earlier and have better prognosis than those with maxillary sinus tumors
  • Overall 5 year survival of nasal squamous cell carcinoma is ~60% versus 42% for maxillary sinus tumor
  • Prognosis usually correlates with tumor stage (Arch Otolaryngol Head Neck Surg 2007;133:131)
  • Nonkeratinizing squamous cell carcinoma usually has better prognosis than keratinizing type
Case reports
  • 60 and 85 year old patients with basaloid squamous cell carcinoma of maxillary sinus (Oncol Lett 2013;5:1755)
Treatment
  • Complete surgical resection and adjuvant radiotherapy
Gross description
  • Variegated appearance: exophytic, fungating or papillary; friable, hemorrhagic or necrotic mass
Gross images

Images hosted on other servers:

Maxillectomy and orbital exenteration specimen

Microscopic (histologic) description
  • Two broad microscopic subtypes:
    • Keratinizing squamous cell carcinoma:
      • 80 - 85% cases
      • Histologically identical to squamous cell carcinoma at other mucosal sites in head and neck; either well, moderately or poorly differentiated
    • Nonkeratinizing (cylindrical cell / transitional) carcinoma
  • Morphologic variants:
    • Adenosquamous carcinoma
    • Basaloid squamous cell carcinoma
    • Papillary squamous cell carcinoma
    • Spindle cell carcinoma
    • Verrucous carcinoma
Microscopic (histologic) images

Images hosted on other servers:

Squamous cell carcinoma, nasal cavity

Keratinizing squamous cell carcinoma

Keratinizing squamous cell carcinoma

Nonkeratinizing squamous cell carcinoma


Basaloid SCC: H&E and p63

Squamous cell carcinoma in situ

Positive stains
Additional references