Nose and Sinus Cancers

Determining the Type of Sinonasal Cancer

Only after a pathologist analyzes some cells or actual pieces of tissue from the lesion will your doctor be able to tell you if you have cancer. Remember that not all lumps and bumps inside the nose and sinuses are cancer. Some growths are benign (non-cancerous), and there are some tumors that are on the borderline between benign and malignant (cancerous). You should speak to your doctor about the best treatment for these in your specific case. In many cases, borderline growths should be removed with surgery. Examples of these types of tumors are:

  • Schneiderian papillomas: These might be related to HPV infections, and they can be found on the front part of the nasal septum (fungiform-type) or on the lateral nasal wall (inverted and cylindrical types). There is a chance of squamous cell carcinoma within some of these papillomas; therefore, they should be surgically removed.

Other borderline tumors include:

  • Angiofibroma
  • Ameloblastoma
  • Fibrous dysplasia
  • Ossifying fibroma
  • Giant cell tumor

Some lesions in the nasal and sinus cavities are in fact cancer. The best way to divide these types of tumors is based on the cell type from which the cancer started.

Epithelial-based cancers include:

  • Squamous cell carcinoma: These are cancers that arise from the lining of the nasal cavity and sinuses. There are a few different subtypes of squamous cell carcinomas, some more aggressive than others. Examples of these include verrucous squamous cell carcinomas (which have less tendency to invade deeply), basloid squamous cell carcinoma and well-to-poorly differentiated squamous cell carcinomas.
  • Adenocarcinoma: This type of cancer arises from gland-like elements in this region that are in the lining of the sinonasal tract or to salivary glands in the area. Adenocarcinoma is the second most common type of sinonasal cancer.
  • Minor salivary gland cancers: There are minor salivary glands in this region of the head and neck as well. Therefore, cancer types can include:
    • Adenocarcinoma
    • Adenoid cystic carcinoma
    • Mucoepidermoid carcinoma
  • Melanoma: These cancers come from skin cells that give skin its color. In rare cases, melanoma can be found in the lining of the mouth, nose and/or throat; this is called mucosal melanoma. Actually, approximately two-thirds of all mucosal melanomas start out in the nasal cavity and paranasal sinuses (another one-third arise in the oral cavity, and the rest are in various other mucosal sites of the head and neck, such as the throat). These are aggressive cancers, even when small.
  • Olfactory neuroblastoma (esthesioneuroblastoma): This is an extremely rare cancer that is thought to begin from the tissue lining in the roof of the nose that is responsible for smell.
  • Sinonasal undifferentiated carcinoma (SNUC): This is a rare but very aggressive cancer. It is unclear what the cell of origin is. It often involves multiple different sites.
  • Neuroendocrine carcinoma

Non-epithelial based sinonasal cancers include:

  • Sarcoma: These are soft tissue tumors that arise from different types of tissues, including fibrous tissue, cartilage, bone, muscles and blood vessels, to name a few. Some examples of sarcomas that have been found in the sinonasal area include:
    • Fibrosarcoma
    • Hemangiopericytoma
    • Angiosarcoma
    • Kaposi’s sarcoma
    • Rhabdomyosarcoma
    • Malignant fibrous histiocytoma
    • Chrondrosarcoma
    • Osteogenic sarcoma
  • Lymphoma: Lymphoid tissue is located all over the body; this is why lymphoma might appear as a lump in the sinonasal area.
  • Chordoma: This is a rare bone tumor that occurs along the spine.

Even more rarely, spread of cancers from other sites could show up in this area as a metastasis. This includes spread of lung, kidney, breast or ovarian cancer.


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