Nasal cavity, paranasal sinuses, nasopharynx

Sinonasal carcinoma

Sinonasal carcinoma-general

Last author update: 1 September 2013
Last staff update: 8 October 2020

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PubMed Search: Sinonasal carcinoma[TIAB]

Rifat Mannan, M.B.B.S., M.D.
Songyang Yuan, M.D., Ph.D.
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Cite this page: Mannan, A.A.S.R. Sinonasal carcinoma-general. website. Accessed December 7th, 2022.
Definition / general
  • Rare and heterogenous malignancy of sinonasal tract
  • Usually maxillary sinus, 20% in ethmoid sinuses
  • < 1% originate in frontal and sphenoid sinuses
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)
  • 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
  • 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

Contributed by Eman Abdelzaher, M.D., Ph.D.

Sinonasal adenoid cystic carcinoma

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