Nasal and Sinus Tumors

About 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. Sixty to 70 percent of these types of tumors occur in the maxillary sinus in the cheek, while 20 to 30 percent are in the nasal cavity and 10 to 15 percent are in the ethmoid sinuses on either side of the nose. Cancer is extremely rare in the sphenoid sinuses behind the ethmoid sinuses and in the frontal sinuses in the forehead.

Several types of cancer can occur in the nasal cavity or the sinuses, including:

  • Squamous cell carcinoma (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 noncancerous 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, wartlike growths in the nose or sinuses. Although about 10 percent are cancerous, most are benign.

What are causes and risk factors for nasal and sinus tumors?

Men are more likely to get sinus cancer than women. 

The most common age for diagnosis of the condition is in the 50s and 60s. 

Smoking and tobacco smoke is a major risk factor for nose and sinus cancer, as well as other cancers of the respiratory tract. Exposure to dusts from wood, leather or textiles, as well as inhaling vapors from glue, formaldehyde, solvents, nickel, chromium, rubbing alcohol and radium appears 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 cancers is unknown, they occur when the genes that control cell growth become defective.

What are the 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

How are nasal and sinus tumors diagnosed?

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 fiber-optic 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 biopsy the suspected mass, either using local or general anesthesia. The removed sample is analyzed by a pathologist to determine whether it is cancerous.

How are nasal and sinus tumors treated?

Surgery, radiation and chemotherapy may be used to treat cancer in the nasal cavity or sinuses. If the tumor is small, it 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, an open surgical approach is often required. The surgeons at the Cedars-Sinai Sinus Center are expert at both the endoscopic and open surgical treatment of these cancers.

Key points

  • Cancerous nasal cavity or sinus tumors are rare, with only about 2,000 being diagnosed in the United States each year.
  • Men are more likely to get sinus cancer than women.
  • The most common age for diagnosis of the condition is in the 50s and 60s. 
  • Smoking is a major risk factor for nose and sinus cancer. Exposure to various substances and vapors also may play a role.
  • These cancers are treated with radiation, chemotherapy and surgery, which can be minially invasive depending on the size of the tumor.
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