Key Points for This Section

Paranasal sinus and nasal cavity cancer is a disease in which malignant (cancer) cells form in the tissues of the paranasal sinuses and nasal cavity. Different types of cells in the paranasal sinus and nasal cavity may become malignant. Being exposed to certain chemicals or dust in the workplace can increase the risk of developing paranasal sinus and nasal cavity cancer. Possible signs of paranasal sinus and nasal cavity cancer include sinus problems and nosebleeds. Tests that examine the sinuses and nasal cavity are used to detect (find) and diagnose paranasal sinus and nasal cavity cancer. Certain factors affect prognosis (chance of recovery) and treatment options.

Paranasal sinus and nasal cavity cancer is a disease in which malignant (cancer) cells form in the tissues of the paranasal sinuses and nasal cavity.

Paranasal sinuses

"Paranasal" means near the nose. The paranasal sinuses are hollow, air-filled spaces in the bones around the nose. The sinuses are lined with cells that make mucus, which keeps the inside of the nose from drying out during breathing.

There are several paranasal sinuses named after the bones that surround them:

• The frontal sinuses are in the lower forehead above the nose.
• The maxillary sinuses are in the cheekbones on either side of the nose.
• The ethmoid sinuses are beside the upper nose, between the eyes.
• The sphenoid sinuses are behind the nose, in the center of the skull.

Nasal cavity

The nose opens into the nasal cavity, which is divided into two nasal passages. Air moves through these passages during breathing. The nasal cavity lies above the bone that forms the roof of the mouth and curves down at the back to join the throat. The area just inside the nostrils is called the nasal vestibule. A small area of special cells in the roof of each nasal passage sends signals to the brain to give the sense of smell.

Together the paranasal sinuses and the nasal cavity filter and warm the air, and make it moist before it goes into the lungs. The movement of air through the sinuses and other parts of the respiratory system help make sounds for talking.

Different types of cells in the paranasal sinus and nasal cavity may become malignant.

The most common type of paranasal sinus and nasal cavity cancer is squamous cell carcinoma. This type of cancer forms in the squamous cells (thin, flat cells) lining the inside of the paranasal sinuses and the nasal cavity.

Other types of paranasal sinus and nasal cavity cancer include the following:

• Melanoma: Cancer that starts in cells called melanocytes, the cells that give skin its natural color.
• Sarcoma: Cancer that starts in muscle or connective tissue.
• Inverting papilloma: Benign tumors that form inside the nose. A small number of these change into cancer.
• Midline granulomas: Cancer of tissues in the middle part of the face.

Being exposed to certain chemicals or dust in the workplace can increase the risk of developing paranasal sinus and nasal cavity cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for paranasal sinus and nasal cavity cancer include the following:

• Being exposed to certain workplace chemicals or dust, such as those found in the following jobs:
  • Furniture-making.
  • Sawmill work.
  • Woodworking (carpentry).
  • Shoemaking.
  • Metal-plating.
  • Flour mill or bakery work.
• Being male and older than 40 years.
• Smoking.

Possible signs of paranasal sinus and nasal cavity cancer include sinus problems and nosebleeds.

These and other symptoms may be caused by paranasal sinus and nasal cavity cancer. Other conditions may cause the same symptoms. There may be no symptoms in the early stages. Symptoms may appear as the tumor grows. A doctor should be consulted if any of the following problems occur:

• Blocked sinuses that do not clear, or sinus pressure.
• Headaches or pain in the sinus areas.
• A runny nose.
• Nosebleeds.
• 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.

Tests that examine the sinuses and nasal cavity are used to detect (find) and diagnose paranasal sinus and nasal cavity cancer.

The following tests and procedures may be used:

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• Physical exam of the nose, face, and neck: An exam in which the doctor looks into the nose with a small, long-handled mirror to check for abnormal areas and checks the face and neck for lumps or swollen lymph nodes.
• X-rays of the head, neck, and chest: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
• Nasoscopy: A procedure to look inside the nose for abnormal areas. A nasoscope is inserted into the nose. A nasoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

• Where the tumor is in the paranasal sinus or nasal cavity and whether it has spread.
• The size of the tumor.
• The type of cancer.
• The patient's age and general health.
• Whether the cancer has just been diagnosed or has recurred (come back).

Paranasal sinus and nasal cavity cancers often have spread by the time they are diagnosed and are hard to cure. After treatment, a lifetime of frequent and careful follow-up is important because there is an increased risk of developing a second kind of cancer in the head or neck.

Glossary Terms

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

A noncancerous growth that does not invade nearby tissue or spread to other parts of the body.

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

A hollow area or hole. It may describe a body cavity (such as the space within the abdomen) or a hole in a tooth caused by decay.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Supporting tissue that surrounds other tissues and organs. Specialized connective tissue includes bone, cartilage, blood, and fat.

To heal or restore health; a treatment to restore health.

The process of identifying a disease, such as cancer, from its signs and symptoms.

A type of paranasal sinus (a hollow space in the bones around the nose). Ethmoid sinuses are found in the spongy ethmoid bone in the upper part of the nose between the eyes. They are lined with cells that make mucus to keep the nose from drying out.

Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.

A type of paranasal sinus (a hollow space in the bones around the nose). There are two, large frontal sinuses in the frontal bone, which forms the lower part of the forehead and reaches over the eye sockets and eyebrows. The frontal sinuses are lined with cells that make mucus to keep the nose from drying out.

A type of tumor in which surface epithelial cells grow downward into the underlying supportive tissue. It may occur in the nose and/or sinuses or in the urinary tract (bladder, renal pelvis, ureter, urethra). When it occurs in the nose or sinuses, it may cause symptoms similar to those caused by sinusitis, such as nasal congestion. When it occurs in the urinary tract, it may cause blood in the urine.

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

A cell in the skin and eyes that produces and contains the pigment called melanin.

A form of cancer that begins in melanocytes (cells that make the pigment melanin). It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines.

A thick, slippery fluid made by the membranes that line certain organs of the body, including the nose, mouth, throat, and vagina.

By or having to do with the nose.

A thin tube-like instrument used to examine the inside of the nose. A nasoscope has a light and a lens for viewing and may have a tool to remove tissue. Also called rhinoscope.

Examination of the inside of the nose using a nasoscope (or rhinoscope). A nasoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Also called rhinoscopy.

One of many small hollow spaces in the bones around the nose. Paranasal sinuses are named after the bones that contain them: frontal (the lower forehead), maxillary (cheekbones), ethmoid (beside the upper nose), and sphenoid (behind the nose). The paranasal sinuses open into the nasal cavity (space inside the nose) and are lined with cells that make mucus to keep the nose from drying out during breathing.

Cancer that forms in tissues of the paranasal sinuses (small hollow spaces in the bones around the nose) or nasal cavity (the inside of the nose). The most common type of paranasal sinus and nasal cavity cancer is squamous cell carcinoma (cancer that begins in flat cells lining these tissues and cavities).

A doctor who identifies diseases by studying cells and tissues under a microscope.

An exam of the body to check for general signs of disease.

The likely outcome or course of a disease; the chance of recovery or recurrence.

To come back or to return.

The organs that are involved in breathing. These include the nose, throat, larynx, trachea, bronchi, and lungs. Also called respiratory tract.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

A cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

A type of paranasal sinus (a hollow space in the bones around the nose). There are two large sphenoid sinuses in the sphenoid bone, which is behind the nose between the eyes. The sphenoid sinuses are lined with cells that make mucus to keep the nose from drying out.

Flat cell that looks like a fish scale under a microscope. These cells cover inside and outside surfaces of the body. They are found in the tissues that form the surface of the skin, the lining of the hollow organs of the body (such as the bladder, kidney, and uterus), and the passages of the respiratory and digestive tracts.

Cancer that begins in squamous cells, which are thin, flat cells that look like fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

The hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The throat is about 5 inches long, depending on body size. Also called pharynx.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.