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Professional /
Ear, Nose, and Throat Disorders /
Tumors of the Head and Neck /
... /
Paranasal Sinus Cancer /
IN THIS TOPIC

Symptoms and Signs

Diagnosis

Prognosis

Treatment

More Information

OTHER TOPICS IN THIS CHAPTER

Tumors of the Head and Neck
Overview of Head and Neck Tumors
Laryngeal Cancer
Nasopharyngeal Cancer
Oral Squamous Cell Carcinoma
Oropharyngeal Squamous Cell Carcinoma
Jaw Tumors
Otic Tumors
Salivary Gland Tumors
Paranasal Sinus Cancer

ADDITIONAL CONTENT

Test your knowledge

Vocal Cord Paralysis
Vocal cord paralysis has several causes and can be bilateral or unilateral. Unilateral vocal cord paralysis is most common. Approximately one third of unilateral vocal cord paralyses are neoplastic, one third are traumatic, and one third are idiopathic. Of the idiopathic causes, which of the following is the most common? 
Keep Music in Mind

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Paranasal Sinus Cancer

(Sinus Cancer)

By

Bradley A. Schiff

, MD,

  • Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine

Last full review/revision Oct 2019| Content last modified Oct 2019
Click here for Patient Education

Paranasal sinus (PNS) cancer is rare. It usually is squamous cell carcinoma but can also be adenocarcinoma, and it occurs most often in the maxillary and ethmoid sinuses. In most cases its cause is not known, symptoms develop late, and survival is generally poor.

(See also Overview of Head and Neck Tumors.)

Although rare in the US, PNS cancer is more common in Japan and among the Bantu people of South Africa. Men over 40 years are affected most often.

The cause is uncertain, but chronic sinusitis is not believed to be a cause. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) may play a role in some cases. Risk factors include

  • Regular inhalation of certain types of wood, leather, and metal dust

  • Smoking tobacco

Symptoms and Signs

Because the sinuses provide room for the cancer to grow, symptoms usually do not develop until the cancer is well advanced. The following symptoms result from local pressure of the cancer on adjacent structures:

  • Pain

  • Nasal obstruction and discharge

  • Epistaxis

  • Diplopia

  • Ear pain or fullness

  • Facial paresthesias

  • Loose maxillary teeth below the affected sinus

Tumor is sometimes visible in the oral or nasal cavities.

Diagnosis

  • Endoscopy, with biopsy

  • CT and MRI

Endoscopy, CT, and MRI are most often used to locate and help stage the tumor. Biopsy confirms the cell type. Staging, which includes assessing tumor spread to the brain, face, neck, lungs, and lymph nodes, helps determine treatment.

Prognosis

The earlier the cancer is treated, the better the prognosis. Prognosis also depends on histology. Survival is improving but remains generally poor. Overall, about 40% of people will have recurrent disease, and 5-year survival is about 60%.

Treatment

  • Surgery

  • Often radiation

  • Sometimes chemotherapy

Treatment for most early-stage cancers is complete surgical excision. Recent advances in surgical techniques, particularly endoscopic techniques, can sometimes achieve complete tumor excisions, spare surrounding tissues, and achieve reconstruction. If risk of recurrence is high, radiation therapy is given postoperatively. If surgical excision is not realistic or would cause excessive morbidity, radiotherapy plus chemotherapy may be used. In some cases, chemotherapy is given to shrink the tumor; if the tumor responds well to the chemotherapy, it is resected surgically. If not, the tumor can be treated with radiation.

More Information

Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
© 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA)
Salivary Gland Tumors
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Evaluation of the Patient with Nasal and Pharyngeal Disorders Evaluation of the Patient with Nasal and Pharyngeal Disorders
Tumors of the Orbit Tumors of the Orbit

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