Sinonasal Tumor: Symptoms Anatomy Diagnosis And Treatment
Sinonasal Tumor is rare , and is twice more common in males than in females. Given the close proximity of the sinus and nasal cavities to the brain and orbits, it is vital to diagnose and treat these lesions as early as possible in order to avoid significant morbidity such as intracranial spread and vision loss. This post describes the symptoms that suggest the need for careful clinical evaluation, as well as the pertinent anatomy, diagnostic approach, and treatment options for the more common sinonasal tumors.
Signs And Symptoms Of Paranasal Sinus And Nasal Cavity Cancer Include Sinus Problems And Nosebleeds
These and other signs and symptoms may be caused by paranasal sinus and nasal cavity cancer or by other conditions. There may be no signs or symptoms in the early stages. Signs and symptoms may appear as the tumor grows. Check with your doctor if you have any of the following:
- Blocked sinuses that do not clear, or sinus pressure.
- Headaches or pain in the sinus areas.
- A lump or sore inside the nose that does not heal.
- A lump on the face or roof of the mouth.
- Numbness or tingling in the face.
- Swelling or other trouble with the eyes, such as double vision or the eyes pointing in different directions.
- Pain in the upper teeth, loose teeth, or dentures that no longer fit well.
- Pain or pressure in the ear.
Treatment Of Stage Iv Paranasal Sinus And Nasal Cavity Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
- External radiation therapy and/or internal radiation therapy with or without surgery.
- A clinical trial of chemotherapy before surgery or radiation therapy.
- A clinical trial of chemotherapy after surgery or other cancer treatment.
- A clinical trial of chemotherapy and radiation therapy.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
You May Like: Toothache From Sinus Infection Remedy
Why Choose Memorial Sloan Kettering For Your Care
At Memorial Sloan Kettering, we have particular expertise in caring for people with nasal cavity and paranasal sinus cancers. Our team consists of head and neck surgeons, neurosurgeons, plastic surgeons, radiation oncologists, medical oncologists, pathologists, radiologists, and speech and swallow therapists. We are committed to providing state-of-the-art care for people with these rare diseases.
MSKs surgeons have access to the latest equipment. This includes high-definition endoscopes, image guidance, and intraoperative MRI. We have vast experience in techniques that minimize side effects.
Choose Memorial Sloan Kettering because:
What About Other Treatments I Hear About
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.
Recommended Reading: Can You Get Rid Of A Sinus Infection Without Antibiotics
Risk Groups For Nasal And Sinus Cancer
Several factors are known to increase the risk of developing nasal and sinus cancer.
These include:
- prolonged exposure to certain substances through your work including wood dust, leather dust, cloth fibres, nickel, chromium and formaldehyde
- smoking the more you smoke, the higher your risk of developing several types of cancer, including nasal and sinus cancer
- human papillomavirus a group of viruses that affect the skin and moist membranes, such as the mouth and throat
Positron Emission Tomography Scan
A PET scan uses a slightly radioactive form of sugar that’s injected into your blood and collects mainly in cancer cells. A special scanner is then used to create pictures of the places where the radioactivity collected in your body.
A PET scan may be used to look for possible areas of cancer spread, or if a CT or MRI scan does not show an obvious tumor. This test also can be used to help see if a change seen on another imaging test is cancer or not.
PET/CT scan: A PET scan is often done along with a CT scan using a machine that can do both scans at the same time. This lets the doctor compare areas of higher radioactivity on the PET scan with the detailed pictures from the CT scan.
You May Like: Dental Implant Protruding Into Sinus
Nasal Cavity And Ethmoid Air Cells
Carcinoma
The presenting symptoms and signs of nasal fossa tumors are similar to those associated with nasal polyps chronic unilateral nasal discharge, ulcer, obstruction, anterior headache, and intermittent nosebleeds. This similarity often leads to delays in diagnosis. Other symptoms and signs include nasal ulcer, tenderness, facial swelling, or pain.22 Invasion of the orbital cavity may produce a palpable medial orbital mass, proptosis, and diplopia obstruction of the nasolacrimal duct causes epiphora involvement of the olfactory region may produce anosmia and expansion of the nasal bridge and extension through the cribriform plate results in frontal headache.
The presenting symptoms and signs of ethmoid air cell tumors are sinus ache and referred pain to the nasal or retrobulbar region, subcutaneous mass at the inner canthus, nasal obstruction and discharge, diplopia, and proptosis.
Physical assessment should include examination of the nasal cavity and nasopharynx with an endoscope after mucosal decongestion and topical anesthesia, evaluation of cranial nerves , and palpation of the nose bridge, cheek, and medial orbital cavity.
Imaging information on CT and MRI can be found on the Expert Consult website.
Esthesioneuroblastoma
eFigure 36-6. Esthesioneuroblastoma, primary site of disease.
- â¢
Allen M. Chen MD, … A. Dimitrios Colevas MD, in, 2010
What Is Sinus Cancer
Cancers occurring in the nasal cavity and the sinuses that branch off of it are rare. Most sinus cancers are squamous cell carcinomas that originate in the lining of the sinuses or nasal cavity. Less common types of sinus and nasal cavity cancers include melanomas and sarcomas . Only about 2,000 people develop any type of nasal or sinus cancer each year in the United States .
Many of the symptoms of sinus cancer resemble those of inflammation or infection of the sinuses , such as congestion, postnasal drip, , pain under the eyes or above the eyebrows, and earache or toothache. Nosebleeds and can also occur. Unlike the symptoms of inflammation and infection, the symptoms of sinus cancer do not improve.
Treatment of sinus depends upon the type of cancer present, where it is located, its size, whether it has spread, and your overall health status. Surgery is often part of treatment, and may be preceded or followed by or chemotherapy.
Complications of sinus cancer requiring emergency care are rare. Seek immediate medical care for a nosebleed that will not stop or extremely severe . Seek prompt medical care if you have symptoms of that persist for more than a couple weeks get frequent bloody noses develop double vision, facial , or a change in facial appearance or have other symptoms that concern you.
Read Also: How To Clear Up Sinus And Ear Congestion
Tests That Examine The Sinuses And Nasal Cavity Are Used To Diagnose Paranasal Sinus And Nasal Cavity Cancer
The following tests and procedures may be used:
How Do I Know If I Have It
If youâre experiencing a combination of symptoms that donât go away over time, see your doctor. Theyâll do a physical exam. Theyâll ask about your symptoms, medical history, and any related risk factors. If they suspect sinus and nasal cavity cancer, theyâll send you to a specialist for more tests.
They might also order a number of imaging tests to help locate your tumor. These include X-rays, CT scans, and MRIs. These can also help determine if the cancer has spread.
Once your doctor locates your tumor, theyâll do a biopsy. That means heâll remove a small tissue sample from the tumor and send it to a lab for testing. If you do have cancer, a biopsy can help identify what type and how aggressive it is. Once your doctor knows these things, heâll be able to decide on the proper treatment plan.
Don’t Miss: Constant Allergies And Sinus Problems
Treatment Of Stage I Paranasal Sinus And Nasal Cavity Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of stage I paranasal sinus and nasal cavity cancer depends on where cancer is found in the paranasal sinuses and nasal cavity:
- If cancer is in the maxillary sinus, treatment is usually surgery with or without radiation therapy.
- If cancer is in the ethmoid sinus, treatment is usually radiation therapy and/or surgery.
- If cancer is in the sphenoid sinus, treatment is the same as for nasopharyngeal cancer, usually radiation therapy. for more information.)
- If cancer is in the nasal cavity, treatment is usually surgery and/or radiation therapy.
- For inverting papillomas, treatment is usually surgery with or without radiation therapy.
- For melanomas and sarcomas, treatment is usually surgery with or without radiation therapy and chemotherapy.
- For midline granulomas, treatment is usually radiation therapy.
- If cancer is in the nasal vestibule, treatment is usually surgery or radiation therapy.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
Read Also: Techniques To Relieve Sinus Pressure
Symptoms Of Nasal And Sinus Cancers
Many of the symptoms of tumors arising in the nose and sinuses are also associated with the more common conditions of nasal allergy and chronic sinusitis. This can cause a delay in a definitive diagnosis in some cases. If the symptoms do not resolve, imaging tests can be performed to rule out the presence of the tumor.
Patients with benign tumors or cancer within the nose and sinuses often have headaches and dirty drainage from the nose, nosebleeds, nasal blockages, a lump on the face or in the roof of the mouth or protruding eye. In some cases, the cancer can spread to the lymph nodes of the neck, but it is not common.
Signs of paranasal sinus and nasal cavity cancer include sinus problems and nosebleeds. Other symptoms may include:
- Blocked sinuses that do not clear, or sinus pressure
- Headaches or pain in the sinus areas
- A lump or sore inside the nose that does not heal
- A lump on the face or roof of the mouth
- Numbness or tingling in the face
- Swelling or other trouble with the eyes, such as double vision or the eyes pointing in different directions
- Pain in the upper teeth, loose teeth, or dentures that no longer fit well
- Pain or pressure in the ear
In the early stages, there may be no signs or symptoms. Signs and symptoms may appear as the cancer advances. If you are experiencing any of these symptoms, contact your physician.
Cancer Support Services
Looking for a Cancer Second Opinion?
Don’t Miss: Is Zinc Good For Sinus Infections
How Do You Treat A Sinus Tumor
The exact treatment for a sinus tumor depends on where its located and whether or not its cancerous.
In cases of benign sinus tumors, treatment for most people is complete removal. Nearly 100 percent of these cases are curable with an endoscopic endonasal approach. Visible skin excisions are often not necessary.
For those sinus tumors determined to be cancerous, nearly all treatment plans will likely include a surgical procedure. While many malignant tumors can be removed endonasally, some may require a combined external approach.
If the tumor is large or in an area where removal will be difficult, you might have radiation treatment first. Radiation treatments can shrink the tumor and make it easier to remove surgically.
Other treatments include:
- Radiation therapy.Radiation therapy might also be given after the tumor is removed to kill additional tumor cells. In some cases, radiation therapy might be the only treatment. This can be done when the person isnt a good candidate for surgery or doesnt want to have surgery.
- Chemotherapy. Cancerous sinus tumors that have begun to spread throughout the body sometimes require chemotherapy treatment. Chemotherapy uses strong medications to kill cancer cells.
- Additional surgery. Sinus tumors can spread to nearby lymph nodes. If this happens, a doctor might recommend surgery to remove those lymph nodes.
Help Getting Through Cancer Treatment
People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.
Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.
Different types of programs and support services may be helpful, and can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.
The American Cancer Society also has programs and services including rides to treatment, lodging, and more to help you get through treatment. Call our National Cancer Information Center at 1-800-227-2345 and speak with one of our trained specialists.
Read Also: Severe Sinus And Cold Relief
Surgery For Paranasal Sinus Cancer
Surgery may be used to take out the cancer and a small amount of healthy tissue around it. In some cases, all or part of the paranasal sinus or the bone near the eye socket, roof of the mouth, or nose may need to be removed. Surgery may also be used to take out lymph nodes in the neck that might have cancer.
Surgery can also be used to help you do things that the cancer may have changed. For instance, if you cant swallow because of the tumor, surgery may be done to put in a feeding tube. Some surgeries can even help rebuild part of the roof of the mouth to help you eat or the eye socket.
Side effects of surgery
Any type of surgery can have risks and side effects. Ask the doctor what you can expect. If you have problems, let your doctors know. Doctors who treat people with nasal cavity and paranasal sinus cancers should be able to help you with any problems that come up.
Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as immunotherapy, chemotherapy, surgery, or radiation therapy.
Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.
Don’t Miss: Does Secondhand Smoke Cause Sinus Problems
Symptoms Of Nasal Cavity And Paranasal Sinus Cancer
Cancer in the nasal cavity or paranasal sinuses usually doesn’t cause any signs or symptoms in its early stages. This is because the nasal cavity and paranasal sinuses are large spaces that allow a tumour to grow. Signs and symptoms often appear as the tumour grows into surrounding tissues. Because nasal and paranasal sinus cancer is not very common, other health conditions, such as a deviated septum or allergies, can cause the same symptoms as nasal cavity and paranasal sinus cancer.
The most common symptom of nasal cavity and paranasal sinus cancer is a stuffy, blocked or runny nose. It usually happens on one side of the nose and lasts for a long time even though you don’t have a cold or allergies. These symptoms may gradually get worse. Other signs and symptoms of nasal cavity and paranasal sinus cancer may include:
- pain above or below the eyes
- a lump or growth on the face, on the roof of the mouth or inside the nose
- watery eyes causing tears to run down the cheek
- numbness, pain or swelling of the face
- loose or numb upper teeth or changes in how dentures fit
- bulging of one eye
- loss or change in vision
- pain or pressure in one of the ears