Nasal cavity, paranasal sinuses, nasopharynx
Sinonasal carcinoma
Squamous cell carcinoma
Last author update: 1 December 2013
Last staff update: 5 March 2021
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PubMed Search: Squamous cell carcinoma[TI] sinonasal
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Etiology | Clinical features | Prognostic factors | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosis | Additional referencesCite this page: Mannan A.A.S.R. Squamous cell carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/nasalscc.html. Accessed October 3rd, 2023.
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
- Reported risk factors include exposure to nickel, chlorophenols, textile dust, thorotrast and smoking (Int J Otolaryngol 2013;2013:672621)
- May develop from Schneiderian papilloma and be associated with HPV (Laryngoscope 2001;111:1104)
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
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
- Keratinizing squamous cell 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:
Keratinizing squamous cell carcinoma
Nonkeratinizing squamous cell carcinoma
Basaloid SCC: H&E and p63
Differential diagnosis
- Postchemotherapy changes
- Scheinederian papillomas
Additional references
