Neoplasms of the nose and paranasal sinuses

Proven content

Malignant neoplasms of the nose and paranasal sinuses are not very common, as they constitute approx. 0,3% of the total number of malignant tumors in humans. They usually occupy the frontal and ethmoid sinuses. They are characterized by abnormal growth of epithelial cells that lines the nasal cavity and sinuses. This only applies to cancers that are de facto epithelial in origin. This type of tumor is usually malignant.

What are cancers of the nose and paranasal sinuses?

These types of cancer are characterized by abnormal growth of the epithelial cells that line the nasal cavity and paranasal sinuses. Cancerous tumors are usually malignant and advanced. This is because the diagnosis is too late, as cancer of the nose and paranasal sinuses gives little specific symptoms. However, these types of tumors are not very common as they account for only 0,3% of all malignant tumors. Moreover, they have a low ability to metastasize through the lymphatic and blood vessels routes.

The causes of cancer of the nose and paranasal sinuses have not been fully specified and defined. However, smoking, exposure to chemicals and wood dust are expected to have a major impact on the disease.

Factors influencing the occurrence of cancer

Among the factors that increase the risk of cancer of the nose and paranasal sinuses:

1. male sex – the cancer affects men much more often than women, especially between 50 and 70 years of age;
2. people exposed to contact with chromium or nickel (e.g. construction workers) – there is a risk of squamous cell carcinoma in this group;
3. people working in the wood industry – are at risk of developing sinus adenoma;
4. work with isopropyl alcohol distillation;
5. work in the production of footwear and all kinds of textiles;
6. human papillomavirus infection with HPV or EBV;
7. smoking.

Types of neoplasms of the nose and paranasal sinuses

Both malignant and benign types of tumors can develop from different tissues, therefore tumors are distinguished:

1. derived from inflammatory cells;
2. soft tissues;
3. blood-lymphatic;
4. bone and cartilage;
5. neuroectodermal;
6. epithelial origin (these include squamous cell carcinoma, adenomas and other epithelial tumors, e.g. papillomas of the paranasal sinuses).

Symptoms of tumors of the nose and paranasal sinuses

Symptoms that may raise the risk of a malignant tumor of the nose or paranasal sinuses include:

1. worsening difficulty in breathing through the nose, clearly visible on one side
2. obstruction in one nasal passage
3. discharge of purulent fluid from the nose, in which blood may appear,
4. recurrent bleeding from one nasal passage,
5. thickening or bulging of the soft tissues on one side, near the cheek or nose
6. movement of the healthy upper teeth (usually on one side) and thickening of the hard palate,
7. exophthalmos, lacrimation, severe pain in healthy teeth (late symptoms).

Diagnosis of neoplasms of the nose and paranasal sinuses

As mentioned above, the diagnosis of early stage neoplasms is almost impossible because their symptoms are not very specific. The basis for the diagnosis of cancer of the nose and paranasal sinuses is a physician’s palpation (assessment of the lymphatic system) and careful examination of the nose with endoscopy and ultrasound of the lymphatic system of the neck. Changes inside the nasal passage can be detected by rhinoscopy and endoscopic examination. On the other hand, the most important examination is a biopsy, during which material for histopathological examination is collected (sometimes this type of examination is extended to include immunohistochemical diagnostics when rare tumors, e.g. melanoma are detected). In addition, computed tomography is performed, which reveals any cavities and pathologies in the nasal cavity and paranasal sinuses.

In addition to the above-mentioned diagnostic methods, attention should also be paid to the symmetry of the patient’s face. It is important to determine whether you have exophthalmos, deformity of the cheek or collapse of the eyeball.

Neoplasms of the nose and paranasal sinuses – treatment

Treatment for this type of tumor is not as effective as it is for tumors located elsewhere, since the tumors of the nose and paranasal sinuses develop implicitly in the initial period. However, if noticed signs of malignant tumor growth are noticed in time, there is a chance for effective treatment. Therefore, in the event of the appearance of any of the above-mentioned symptoms, you should immediately consult an ENT doctor.

Usually, surgery is performed with reconstruction, followed by complementary radiotherapy or chemotherapy. This is standard management of malignant neoplasms. The type of treatment should be selected on an individual basis, therefore the following factors should be taken into account:

1. organ advancement,
2. tumor histology,
3. general condition of the patient,
4. invasive surgery,
5. the possibility of reconstruction and combined treatment,
6. social and economic factors,
7. the patient’s expectations of doctors.

Among the surgical methods, we can distinguish resection:

1. partial upper jaw with removal of the contents of the orbit,
2. total jaw with or without removing the contents of the orbit,
3. middle partial jaw,
4. partial lower jaw.

The chances of a complete recovery of the cancer of the nose and paranasal sinuses is about 40 percent. In contrast, five-year survival is about 20-40% depending on the stage of the tumor, its distribution and tumor histology.

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