Cancer of the Nasal Cavity and Paranasal Sinuses

Cancer of the Nasal Cavity and Paranasal Sinuses

·        Inflammatory Polyp:

o   Not a true tumour: overgrowth of stromal tissue – no malignant potential

o   Common in adults, rare in children

o   Associated with cystic fibrosis

·        Sinonasal papilloma: 

o   Benign. Can become malignant. 3% become malignant after removal (poor prognosis). 3% have malignancy in polyp (prognosis better)

o   Usually in adult.  Presents with nasal obstruction and painless epistaxis

o   ?Associated with HPV 6 & 11

·        Sinonasal Carcinoma:

o   Occupational association: wood turners (adenocarcinoma) and nickel mining

o   Relatively rare (<1% of cancer deaths)

o   60% 5 year survival, surgical treatment

o   Squamous cell most common (look for keratin whirls), also adenocarcinoma

o   Stromal overgrowth = desmoplasia Þ sign of invasive cancer

·        Nasopharyngeal Carcinoma: 

o   Most common in SE Asia and N Africa, occurs in 15 – 25 and 60 – 69. Presents with epistaxis or obstructed eustachian

o   No occupational association

o   Associated with EBV

o   Biphasic tumour: Small cells superimposed on squamous cell carcinoma, with lots of lymphocytes

o   (don‟t confuse with lymphoma)

o   Aggressive: early lymph node spread

o   Treatment: radiotherapy +/- surgery