Nasal and Sinus Tumors
Nasal and sinus tumors are benign or cancerous tumors that occur in the nose or sinuses. Cancerous nasal cavity or sinus tumors are rare, with only about 2,000 being diagnosed in the United States each year. Most of these types of tumors (60 to 70 percent) occur in the maxillary sinus, while 20 to 30 percent are in the nasal cavity and 10 to 15 percent are in the ethmoid sinuses. Cancer in the sphenoid or frontal sinuses is extremely rare, accounting for only 5 percent of such cancers.
Causes and Risk Factors of Nasal and Sinus Tumors
Men are more likely to get sinus cancer than women. The most common age for diagnosis of the condition is fifties and sixties. Smoking and tobacco smoke is a major risk factor for nose and sinus cancer, as well as other cancers of the respiratory track. Exposure to dusts from wood, leather or textiles, as well as inhaling vapors from glue, formaldehyde, solvents, nickel, chromium, rubbing alcohol and radium appear to increase the risk of such cancers. Avoiding exposure to these risk factors can reduce the risk of sinus or nasal cancer, especially avoiding tobacco smoke.
Although the cause of sinus and nasal cavities is unknown, they occur when the genes that control cell growth become defective.
Types of Sinus and Nasal Cancer
A number of different types of cancer can occur in the nasal cavity or the sinuses, including:
- Squamous cell carcinoma (most common; about 70 percent of such cancers) occurs in the respiratory tract
- Adenocarcinoma (about 10 to 20 percent) occurs in the sinus lining
- Lymphomas (about 5 percent of such cancers) are caused by cells in the immune or lymphatic system
- Melanomas (about 3 percent) arise from cells in the sinus lining that contain pigment and are very aggressive
- Esthesioneuroblastomas develop from the nerves at the base of the skull, where they enter the nasal cavity and provide a sense of smell.
There are also several types of non-cancerous tumors that, although they do not spread, can cause damage if not treated.
Osteomas usually do not cause any symptoms, but they can impede the frontal, ethmoid or maxillary sinuses. If an osteoma does cause such an obstruction, it needs to be removed surgically.
Viral infections can cause papillomas, which are wart-like growths in the nose or sinuses. Although about 10 percent are cancerous, most are benign.
Symptoms of Nasal and Sinus Tumors
Although many sinus or nasal cancers exhibit no symptoms, certain prolonged symptoms may indicate cancer, including:
- Persistent nasal congestion, especially on one side
- Pain in the forehead, cheek, nose or around the eyes or ear
- Post-nasal drip at the back of the throat
- Frequent and persistent nosebleeds
- Double or blurred vision
- Loss of sense of smell or taste
- Pain or numbness in the face or teeth
- A growth in the face, nose, palate or neck
- Runny eyes
- Difficulty opening the mouth
- Recurrent ear infections
- Difficulty hearing
Diagnosis of Nasal and Sinus Tumors
A medical history and a physical examination of the head and neck is the first step in diagnosing suspected nasal or sinus cancer. A small fiberoptic scope may be used to see into the nasal cavity and sinuses.
If cancer is suspected, a MRI, CT or PET scan may be used to diagnose the condition.
An endoscope can be used to biospy the suspected mass, either using local or general anesthesia. The removed sample is then analyzed by a pathologist in a laboratory to determine whether it is cancerous.
Treatment of Nasal and Sinus Tumors
If cancer is found in the nasal cavity or sinuses, surgery, radiation and chemotherapy may be used to treat it. If the tumor is small, they can often be removed using an endoscopic, minimally invasive approach. If a tumor has spread into the cheek, eye, brain, nerves or other key structures in the skull, then an open surgical approach is often required. The surgeons at the Sinus Center are expert at both the endoscopic and open surgical treatment of sinus and nasal cavity cancers.