Nasal Cavity and Sinus Cancer

The paranasal sinuses are air-filled sacs distributed into several areas of the face.

  • Maxillary sinuses are under the eyes in the cheek bones
  • Frontal sinuses are above the eyes in the forehead area
  • Ethmoid sinuses are between the nose and the eyes
  • Sphenoid sinuses are at the bottom of the skull, under the pituitary gland

The purpose of the paranasal sinuses is not known for certain, but scientists believe the air-filled sacs have several functions:

  • To decrease the weight of the skull
  • To increase voice resonance
  • Protection against blows to the face
  • Insulation of the eyes and roots of teeth against temperature fluctuations
  • To humidify and heat inhaled air
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Symptoms

Early cancer symptoms are often the same as non-cancerous conditions. Early cancer symptoms that mimic common conditions of the sinuses include:

  • A nose bleed from one nostril
  • Blockage of a nostril
  • Runny nose on one side

Symptoms that can indicate an advances cancer tumor are:

  • A persistent headache
  • Changes in vision or double vision

Causes and Risk Factors

Men are affected one-and-one-half more often then women. The disease is more common in people between 45 and 85 years of age.

Approximately 60 to 70 percent of sinus cancers occur in the maxillary sinus. About 20 to 30 percent begin in the nasal cavity, and 10 to 15 percent in the ethmoid sinuses. Less than 10 percent are found in the frontal and sphenoid sinuses.

Squamous cell carcinoma and adenocarcinoma are associated with exposure to products found in furniture making, the leather industry, and the textile industry:

  • Wood dust, nickel dust
  • Mustard gas
  • Isopropyl oil
  • Chromium
  • Dichlorodiethyl sulfide

Some viral infections can cause sinus cancer. The human papilloma virus (HPV) can produce a benign (non-cancerous) sinus tumor called inverted papilloma.

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Diagnosis

To make a diagnosis of nasal cavity cancer or sinus cancer the doctor will ask questions about your symptoms, medical history, and examine your mouth. 

An examination of the ears, nose, and neck is also needed to help determine if the tumor has spread.

If your examination needs further investigation, your doctor may order a biopsy in order to diagnosis the type of cancer present. A Biopsy is conducted with tissue that is removed so that a pathologist may examine its cells under a microscope.

Doctors may order a traditional X-ray and other imaging tests to gather information about the tumor.  Those tests include:

CT scan - A special type of X-ray that makes a series of detailed pictures, with different angles, of areas inside the mouth and neck. A computer is linked to the X-ray machine. A dye may be injected into a vein or swallowed in a pill to help the organs or tissues show up on the X-ray. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

Magnetic Resonance Imaging (MRI) - A machine that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the mouth and neck. This procedure is also called nuclear magnetic resonance imaging (NMRI).

PET Scan - A PET scan helps determine if a tumor has spread to other areas in the body. During a positron emission tomography scan (PET), a small amount of radioactive sugar (glucose) is injected into a vein. The scanner makes computerized pictures of the areas inside the body. Cancer cells absorb more radioactive glucose than normal cells, so the tumor is highlighted on the pictures.

Many types of cancer grow in the sinuses and can metastasize (spread to other parts of the body):

  • Inverted papilloma (not cancer but can become cancerous)
  • Squamous cell carcinoma
  • Verrucous carcinoma
  • Basaloid squamous cell carcinoma
  • Spindle cell carcinoma
  • Transitional cell or cylindrical cell carcinoma
  • Adenocarcinoma
  • Sinonasal undifferentiated carcinoma (SNUC)
  • Small-cell carcinoma
  • Lymphoma
  • Malignant melanoma
  • Salivary-type neoplasms
  • Sarcoma
  • Metastic tumors