General Information
The majority of tumors of the paranasal sinuses present with advanced disease,
and cure rates are generally poor (≤50%). Squamous cell carcinoma is the most frequent
type of malignant tumor in the nose and paranasal sinuses (70%–80%).
Papillomas are distinct entities that may undergo malignant degeneration. The
cancers grow within the bony confines of the sinuses and are often asymptomatic
until they erode and invade adjacent structures.[1-3]
Pretreatment evaluation and staging, as well as the need for
multidisciplinary planning of treatment, is very important. Generally, the
first opportunity to treat patients with head and neck cancers is the most
effective, though occasionally salvage surgery or salvage radiation therapy,
as appropriate, may be successful. Since most treatment failures occur
within 2 years, the follow-up of patients must be frequent and meticulous
during this period. In addition, because nearly 33% of these patients
develop second primary cancers in the aerodigestive tract, a lifetime of
follow-up is essential.
Nodal involvement is
infrequent. Although metastases from both the nasal cavity and paranasal sinuses may occur, and distant metastases are found in 20% to 40% of
patients who do not respond to treatment, locoregional recurrence accounts for the majority of cancer deaths since most patients die of direct extension into vital areas of the skull or of
rapidly recurring local disease.
Cancers of the maxillary sinus are the most common of the paranasal sinus
cancers. Tumors of the ethmoid sinuses, nasal vestibule, and nasal cavity are
less common, and tumors of the sphenoid and frontal sinuses are rare.
The major lymphatic drainage route of the maxillary antrum is through the
lateral and inferior collecting trunks to the first station submandibular,
parotid, and jugulodigastric nodes and through the superoposterior trunk to
retropharyngeal and jugular nodes.
Some data indicate that various industrial exposures may be related to cancer
of the paranasal sinus and nasal cavity. The risk of a second primary head and
neck tumor is considerably increased.[4]
References
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Mendenhall WM, Riggs CE Jr, Cassisi NJ: Treatment of head and neck cancers. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2005, pp 662-732.
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Laramore GE, ed.: Radiation Therapy of Head and Neck Cancer. Berlin: Springer-Verlag, 1989.
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Thawley SE, Panje WR, Batsakis JG, et al., eds.: Comprehensive Management of Head and Neck Tumors. 2nd ed. Philadelphia, Pa: WB Saunders, 1999.
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Johns ME, Kaplan MJ: Advances in the management of paranasal sinus tumors. In: Wolf GT, ed.: Head and Neck Oncology. Boston, Mass: Martinus Nijhoff Publishers, 1984, pp 27-52.
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