Nasal cavity and paranasal sinus cancer

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Cancerous tumours of the nasal cavity and paranasal sinuses

A cancerous tumour of the nasal cavity or a paranasal sinus can spread, or 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 share the same symptoms such as a stuffy, blocked or runny nose, mucus or bloody discharge from the nose, headache and sinus pain.

About 60%–70% of all nasal cavity and paranasal sinus cancers develop in the maxillary sinus. Tumours can also develop in the nasal cavity and ethmoid sinuses. Cancerous tumours of the frontal sinus or sphenoid sinus are very rare. They make up less than 5% of all nasal cavity and paranasal sinus cancers.

Squamous cell carcinoma

Squamous cell carcinoma (SCC) starts in the flat, thin cells that cover many of the outer and inner surfaces of the body, including the mucosal lining of the nasal cavity and paranasal sinuses.

About 70%–80% of all nasal cavity and paranasal sinus cancers are SCC.

Almost all cancers found in the nasal vestibule are SCCs. Verrucous carcinoma, basaloid SCC, spindle cell carcinoma and transitional cell carcinoma are examples of subtypes of SCC found in the nasal vestibule and paranasal sinuses.

Minor salivary gland cancer

The minor salivary glands are very small glands found in the mucosal lining of the mouth, hard and soft palates, the nasal cavity and the paranasal sinuses.

Minor salivary gland cancer makes up about 10%–15% of all nasal cavity and paranasal sinus cancers. Adenoid cystic carcinoma, carcinoma ex-pleomorphic adenoma and mucoepidermoid carcinoma are the types of minor salivary gland cancer that affect the nasal cavity and paranasal sinuses.

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

Find out more about cancerous tumours of the salivary gland.

Adenocarcinoma

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).

Most adenocarcinoma of the nasal cavity or paranasal sinuses are diagnosed in men and are strongly linked to exposure to wood dust.

Neuroendocrine cancer

Neuroendocrine cancer is a rare and varied group of tumours that start in the neuroendocrine system. The neuroendocrine system is a network of nerve-like cells that make hormones and release them into the bloodstream. Neuroendocrine cells are scattered throughout the body. Higher numbers of these cells are found in the organs of the digestive system (including the esophagus, stomach, pancreas or intestine) and the respiratory system (including the nose, paranasal sinuses and lungs).

The following are different types of neuroendocrine cancer of the nasal cavity and paranasal sinuses.

Esthesioneuroblastoma

Esthesioneuroblastoma is a rare tumour that starts in olfactory cells, which are the nervous system cells responsible for smell. It is also called olfactory neuroblastoma. It most often starts in the upper part of the nasal cavity, but it can grow into any of the sinuses as well as the brain. It is a slow-growing tumour that has a better prognosis than other types of nasal cavity and paranasal sinus cancers. Treatment for esthesioneuroblastoma often includes a combination of surgery and radiation therapy and sometimes chemotherapy.

Sinonasal undifferentiated carcinoma

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

Small cell neuroendocrine carcinoma

Small cell neuroendocrine carcinoma in the nasal cavity or a paranasal sinus behaves similar to small cell lung cancer. It is an aggressive tumour that grows quickly, and it is often diagnosed at an advanced stage. Treatment includes a combination of surgery, chemotherapy and radiation therapy.

Rare nasal cavity and paranasal sinus tumours

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

Lymphoma

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 tumour.

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

Find out more about extranodal natural killer (NK)/T-cell lymphoma.

Mucosal melanoma

Melanoma is a type of skin cancer but it can also 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%–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.

Soft tissue sarcoma

Soft tissue sarcomas start in cells of the connective and supporting tissues. The most common types of soft tissue sarcoma that starts in the nasal cavity and paranasal sinuses are hemangiopericytomas. Hemangiopericytomas start in cells that surround blood vessels. Most hemangiopericytomas are slow-growing tumours. They are treated with surgery and radiation therapy.

Find out more about soft tissue sarcoma.

Bone cancer

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.

neoadjuvant therapy

Treatment given to shrink a tumour before the first-line therapy (the first or standard treatment), which is usually surgery.

Neoadjuvant therapy may be given if a tumour is too large to be removed by surgery. It may include chemotherapy, radiation therapy or hormone therapy.

chemoradiation

Treatment that combines chemotherapy with radiation therapy. Chemotherapy is given during the same time period as radiation therapy. Some types of chemotherapy make radiation therapy more effective.

Also called chemoradiotherapy.

mucous membrane

The thin, moist layer of tissue that lines some organs and body cavities, including the nose, mouth, lungs, airways, vagina and gastrointestinal (GI) tract.

Glands in the mucous membrane make mucus (a thick, slippery fluid).

Also called mucosa.

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