It a cancer arising from the lining of the nasal cavity and the sinuses lying around the eye ball. There are 2 paired and 2 unpaired sinuses situate around the eye ball. There are numerous different cell linings (respiratory, olfactory, lymphoid, neuroendocrine, squamous, salivary) in these region leading to various differenttypes of cancers.The primary presentation of any of these cancers mimic routine problems.
Exposure to industrial chemicals, infected with the human papillomavirus (HPV), Exposure to wood, leather, flour, textile, nickel or chromium dus, Exposure to radium, tobacco (snuff).
If you are suffering from unilateral nasal block, nasal bleeding (epistaxis), loss of smell (anosmia), headache or eye ball bulging (proptosis), you need to get yourself evaluated for nose or sinus tumor.
For sinus cancer that is caught early, for example, surgery may be the only treatment required. More advanced cancers may require further treatments, such as radiation therapy,chemotherapy and/or targeted therapy, in combination with or instead of surgery. Most cases the surgical management is done endoscopically. For advanced tumors involving eye, overlying skin or bones, open surgical approaches needs to be planned along with necessary plastic surgery.
It is very important to do a biopsy of these tumors as it has varied histological types. Some of these tumors are very responsive to non surgical treatment lines like radiation or chemotherapy. Also since the tumors also mimic normal non cancer pathology, without confirming surgery for benign conditions should not be proceeded to avoid later problems in treatment. The biopsy is a simple procedure mostly done as office based procedure.
The most important imaging modality required for evaluation is a contrast MRI and a plain CT scan of paranasal sinuses. The imaging is generally done following the biopsy report to evaluate the local and distant spread of the disease depending on the report. Plain CT axial cuts done for FESS surgery should not be done to evaluate any nose and sinus pathology.
With advent of endoscopic skull base surgery options, even for locally advanced tumors reading skull base can be managed without opening skull bone. So a scarless surgery is possible although tumors is advanced.
These cancers are locally aggressive and depending on the type of cancer the outcomes vary. Most cancers remain controlled with surgery and additional radiotherapy. However certain worse histology types may have poor local control. These cancers generally do not tend to spread in the body and are localised. Hence the overall outcome of these cancers is good.