Malignancy

• Overview:

  • Nasal cavity cancer
  • Paranasal sinus cancer
  • Rare cancers
  • Exact cause is not known
• Risk factors:

  • Age (>55)
  • Male
  • Handle/breathing certain chemicals or dusts for many years e.g. formaldehyde, wood dust, glues
  • Smoking
  • HPV
• Symptoms depend on site:

  • Ocular effects: proptosis, diplopia, epiphora (excessive tears)
  • Nasal effects (unilateral): obstruction, bloody nasal discharge/nosebleeds, crusting, pain, anosmia
  • Oral effects: loose teeth, ill-fitting dentures, palatal swelling
  • Facial effects: facial swelling, paraesthesia
  • Metastatic lymph nodes in neck
  • Retro-antral spread causing trismus or trigeminal neuralgia
• Investigations:

  • If concerned need 2ww referral (unilateral blockage + bloody discharge)
  • Likely to need nasoendoscopy, biopsy and imaging (CT and/or MRI)
• Treatment options:

  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Immunotherapy
• Prognosis:

  • Generally poor due to late presentation
  • 5 year survival around 30%