Cancerous tumours of the nasal cavity and paranasal sinuses

A cancerous tumour of the nasal cavity or paranasal sinus can grow into nearby tissue and destroy it. The tumour can also spread (metastasize) to other parts of the body. Cancerous tumours are also called malignant tumours.

It is often difficult for a doctor to tell the difference between a non-cancerous tumour and a cancerous tumour of the nasal cavity or paranasal sinuses. Non-cancerous tumours and cancerous tumours have the same symptoms such as a stuffy, blocked or runny nose, mucus or bloody discharge from the nose, headache and sinus pain.

About 70% of all nasal cavity and paranasal sinus cancers start in the maxillary sinus. Tumours can also start in the nasal cavity and ethmoid sinuses. Cancerous tumours of the frontal sinus or sphenoid sinus are very rare.

The most common cancerous tumours of the nasal cavity and paranasal sinuses are:

• squamous cell carcinoma
• minor salivary gland cancer
• adenocarcinoma
• neuroendocrine cancer

Squamous cell carcinoma (SCC) starts in the flat, thin cells that cover many of the surfaces inside and outside of the body, including the mucous membrane in the nasal cavity and paranasal sinuses.

Over 80% of all nasal cavity and paranasal sinus cancers are SCC. Subtypes of SCC include:

• verrucous carcinoma
• basaloid SCC
• spindle cell carcinoma
• papillary squamous cell carcinoma
• non-keratinizing squamous cell carcinoma

The salivary glands are very small glands found in the mucous membrane in the mouth, hard and soft palates, the nasal cavity and the paranasal sinuses.

Minor salivary gland cancer makes up about 10% to 15% of all nasal cavity and paranasal sinus cancers.

The types of minor salivary gland cancer that affect the nasal cavity and paranasal sinuses are:

• adenoid cystic carcinoma
• carcinoma ex-pleomorphic adenoma
• mucoepidermoid carcinoma

Minor salivary gland cancer is usually treated with both surgery and radiation therapy.

Find out more about cancerous tumours of the salivary gland.

Adenocarcinoma starts in gland cells in the nasal cavity or paranasal sinuses. This type of tumour is most often found in the upper part of the nasal cavity and the ethmoid sinuses. Adenocarcinoma can be slow growing (low grade) or fast growing (high grade).

Some of these tumours diagnosed in men are strongly linked to breathing in wood dust.

Adenocarcinoma of the nasal cavity and paranasal sinuses is usually treated with both surgery and radiation therapy.

Neuroendocrine cancer is a rare cancer that starts in the neuroendocrine system. The neuroendocrine system is made up of neuroendocrine cells. Neuroendocrine cells are like nerve cells, but they also make hormones and release them into the blood. Neuroendocrine cells are spread throughout the body, but are found most often in the organs of the digestive system and the respiratory system (including the nose, paranasal sinuses and lungs).

Esthesioneuroblastoma is a rare neuroendocrine tumour that starts in the nervous system cells that are responsible for smell (called olfactory cells). It often starts in the upper part of the nasal cavity. It is a slow-growing cancer that has a better prognosis than other types of nasal cavity and paranasal sinus cancers.

Esthesioneuroblastoma is also called olfactory neuroblastoma.

Treatment for esthesioneuroblastoma often includes a combination of surgery and radiation therapy and sometimes chemotherapy.

Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive type of neuroendocrine cancer in the nasal cavity and paranasal sinus. It grows very quickly and spreads to other parts of the body, such as the liver and lungs. SNUC is often treated with chemoradiation followed by surgery.

The following cancerous tumours of the nasal cavity and paranasal sinuses are rare:

Most cases of nasal cavity and paranasal sinus lymphoma are non-Hodgkin lymphoma. Extranodal natural killer (NK)/T-cell lymphoma, a type of non-Hodgkin lymphoma, is most often found in the nasal cavity. It can be a slow-growing or fast-growing cancer.

Nasal cavity and paranasal sinus lymphoma is usually treated with a combination of chemotherapy and radiation therapy.

Melanoma is a type of skin cancer, but it can start in the mucous membranes of the body. It can start in the nasal cavity and, in rare cases, it develops in the paranasal sinuses. About 1% to 2% of all melanomas develop in the nasal cavity and paranasal sinuses. Melanoma in the nasal cavity or paranasal sinuses is often aggressive and is treated with a combination of surgery, radiation therapy and sometimes chemotherapy.

Find out more about melanoma skin cancer.

Soft tissue sarcoma starts in the cells of connective and supporting tissues. The most common type of soft tissue sarcoma of the nasal cavity and paranasal sinuses is glomangiopericytoma. It starts in cells that surround blood vessels. Cancerous glomangiopericytomas are rare. Most glomangiopericytomas are non-cancerous (benign). Benign glomaniopericytomas can grow quickly in the nasal cavity and paranasal sinuses, but they do not spread to other areas of the body.

Find out more about soft tissue sarcoma.

Ewing sarcoma, chondrosarcoma and osteosarcoma are types of bone cancer that can start in the nasal cavity and paranasal sinuses. They are usually treated like other bone cancers.

Find out more about bone cancer.