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Paranasal Sinus Tumors

Paranasal Sinus Tumors

A paranasal sinus tumor is a cancer that has grown inside your sinuses, the open spaces behind your nose.

Illustration of the sinuses
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This tumor can begin in the cells of the membranes, bones, or nerves that line the area. You might not know or even suspect that a tumor is growing until it spreads. The sooner you get a diagnosis and start treatment, the better your chances of beating the cancer.

Causes of paranasal sinus tumors

These are possible causes of paranasal sinus tumors:

  • Exposure to industrial chemicals

  • Being infected with the human papillomavirus

  • Exposure to wood, leather, flour, textile, nickel, or chromium dust

  • Exposure to radium

  • Smoking cigarettes

Symptoms

Early symptoms of paranasal sinus tumors are similar to symptoms of colds or infections, so they're often missed:

  • Blockage of sinuses, or congestion that never goes away

  • Changes in your voice or breathing

  • Reduced sense of smell

  • Numbness and pain in your face, ears, or teeth

  • Teeth that become loose

  • Pus draining from your nose or postnasal drip

  • Growth on your face or palate

  • Eyes that continuously water

  • Bulging eye

  • Loss of vision

  • Difficulty opening your mouth

Call your doctor if you experience any of these symptoms.

Diagnosis

A doctor will typically take your medical history and do a physical exam. The physical exam will include looking at your eyes, ears, nose, mouth, face, neck, and throat. Any details you can provide about any pain you are experiencing, such as whether it's sharp, burning, dull, or achy, where it's located, and when it occurs, can help with the diagnosis.

Your doctor might order an endoscopy of your sinuses. This is a procedure in which a thin tube with a tiny light and a video camera on the end is inserted into your sinuses. Looking inside your sinuses will help your doctor to pinpoint the location and size of the tumor.

Your doctor might order these tests, as well:

  • Blood tests

  • Imaging tests of your skull, such as X-rays of the sinuses

  • Imaging tests of your chest

  • Biopsy, in which a small sample of the tissue from the tumor is removed and examined in the lab for signs of cancer

Staging

Part of the diagnosis process is called staging. This tells your doctor how advanced the cancer is and whether it has spread to other parts of your body. Staging helps your medical team create the best treatment plan for you.

The stage of your cancer depends on where the tumor is, how big it is, whether it has spread to lymph nodes or other parts of your body, and some other health factors. The National Cancer Institute describes stages on a scale from I (the easiest to treat) to IV (the most advanced and difficult to treat). Stages and survival rates for paranasal sinus tumors are:

  • Stage I. The tumor is contained and has not spread; about 63% of patients survive at least 5 years if it is first diagnosed at this stage.

  • Stage II. The tumor has spread into other parts of the sinus; the 5-year survival rate is 61%.

  • Stage III. The tumor has spread into the bone of the sinuses or the eye socket and may have spread to a lymph node; the 5-year survival rate is 50%.

  • Stage IV. The tumor has spread into the eye socket, the brain, or other parts of the skull and neck, and possibly to more distant parts of the body and may have a larger presence in the lymph nodes; the 5-year survival rate is 35%.

Treatment

The most common approach to treating a paranasal sinus tumor is a combination of surgery and radiation therapy. The goal of surgery is to remove as much of the tumor as possible. If the cancer has spread to lymph nodes, they will be removed as well. Surgery will be planned to preserve as much of your face and function as possible. Surgery can be complex and may involve a variety of specialists, such as otorhinolaryngologists (ENT), neurosurgeons, and maxillofacial surgeons.  

Radiation therapy may be given before surgery to attempt to shrink the tumor or after surgery to destroy any remaining cancer cells. In this case, it will usually start several weeks after your surgery to allow enough time for your body to heal. 

Chemotherapy, the use of drugs that destroy cancer cells, is often used for cancers that return after the first treatment approach and is determined on a case-by-case basis. You might be given a combination of chemotherapy drugs or a combination of chemotherapy and radiation, called chemoradiation.

Treatment will also include pain management. Let your doctor or nurse know if you are in pain so it can be better managed.

Complications

Paranasal sinus tumors and their treatment may lead to these complications:

  • Scarring from surgery

  • Changes over the long term in breathing, speech, chewing, or swallowing, caused by the tumor or surgery

  • Nerve damage that can affect sensation in your face and movement in your face, shoulder, or arms

  • Side effects from radiation therapy, such as pain, nausea, trouble eating, sores in your mouth, and changes in taste

  • Metastasis, or spreading of the cancer, to other parts of your body

Patients who are treated for paranasal sinus tumors should continue to meet regularly with their doctor. If the cancer returns, it is most likely to happen in the first 2 years after treatment. 

 

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