Sinonasal Cancers: Diagnosis and Management

Abstract

Sinonasal cancers are rare tumors constitute 3% of head and neck cancers. These include malignancies of the nasal cavity and paranasal sinuses (maxillary sinus, ethmoid sinuses, frontal sinus and sphenoid sinus). Patients are often asymptomatic until late in the course of their disease. Tumors of the maxillary sinus are more common than those of the ethmoid sinus or nasal cavity. The workup for patients with suspected paranasal sinus tumors includes complete head and neck CT/MRI with contrast. FDG-PET/CT may be considered in the workup of patients with clinically apparent stage III or IV disease. The most common histology for these tumors is squamous cell carcinoma, others reported includes adenocarcinoma, esthesioneuroblastoma, minor salivary gland tumors, or sinonasal neuroendocrine carcinoma [SNEC]). Surgical resection for all T stages (except T4b, any N) followed by postoperative therapy remains a cornerstone of treatment. However, definitive RT or systemic therapy/RT is recommended for T4b, any N. Locoregional control and incidence of distant metastasis are dependent on T stage, N stage, and tumor histology.