Nasal and sinus tumours are benign or cancerous growths that occur in the nose or sinuses.

Cancerous nasal cavity or sinus tumours are rare. The majority occur in the maxillary sinus in the cheek, while 20 to 30 percent are in the nasal cavity and 10 to 15 percent are in the ethmoid sinuses on either side of the nose. Cancer is extremely rare in the sphenoid sinuses behind the ethmoid sinuses and in the frontal sinuses in the forehead.

Several types of cancer can occur in the nasal cavity or the sinuses, including:

• Squamous cell carcinoma
• Adenocarcinoma
• Lymphomas
• Melanomas
• Esthesioneuroblastomas

There are also several types of noncancerous tumours that, although they do not spread, can cause damage if not treated.

Osteomas usually do not cause any symptoms, but they can impede the frontal, ethmoid or maxillary sinuses. If an osteoma does cause such an obstruction, it needs to be removed surgically.

Viral infections can cause papillomas, wartlike growths in the nose or sinuses. These have a small chance of harbouring malignant cells.

What are causes and risk factors for nasal and sinus tumours?

Men are more likely to get sinus cancer than women.

The most common age for diagnosis of the condition is in the 50s and 60s.

Smoking and tobacco smoke is a major risk factor for nose and sinus cancer, as well as other cancers of the respiratory tract. Exposure to dusts from wood, leather or textiles, as well as inhaling vapors from glue, formaldehyde, solvents, nickel, chromium, rubbing alcohol and radium appears to increase the risk of such cancers. Avoiding exposure to these risk factors can reduce the risk of sinus or nasal cancer, especially avoiding tobacco smoke.

Although the cause of sinus and nasal cancers is unknown, they occur when the genes that control cell growth become defective.

What are the symptoms of nasal and sinus tumours?

Although many sinus or nasal cancers exhibit no symptoms, certain prolonged symptoms may indicate cancer, including:

• Persistent nasal congestion, especially on one side
• Pain in the forehead, cheek, nose or around the eyes or ear
• Post-nasal drip at the back of the throat
• Frequent and persistent nosebleeds
• Double or blurred vision
• Loss of sense of smell or taste
• Pain or numbness in the face or teeth
• A growth in the face, nose, palate or neck
• Runny eyes
• Difficulty opening the mouth
• Recurrent ear infections
• Difficulty hearing

How are nasal and sinus tumours diagnosed?

A medical history and a physical examination of the head and neck is the first step in diagnosing suspected nasal or sinus cancer. A small fiber-optic scope may be used to see into the nasal cavity and sinuses.

If cancer is suspected, a MRI, CT or PET scan may be used to diagnose the condition.

An endoscope can be used to biopsy the suspected mass, either using local or general anesthesia. The removed sample is analysed by a pathologist to determine whether it is cancerous.

How are nasal and sinus tumours treated?

Surgery, radiation and chemotherapy may be used to treat cancer in the nasal cavity or sinuses. Your specialist will help you make the decision about what care is best for your individual condition.

Reference. Cedars Sinai ‘Nasal and sinus tumours; patient factsheet’. 2019. For further reading please see https://www.cedars-sinai.org/health-library/diseases-and-conditions/n/nasal-and-sinus-tumors.html