A unilateral maxillary sinus tumor

Surgical Treatment of Maxillary Antrum Neoplasms

Paranasal sinus cancers comprise about 0.3% of all cancers and 80% of these lesions arise in the maxillary sinus. A masquerading primary sinus tumour represents a therapeutic challenge as most patients with maxillary antrum cancer are diagnosed with advanced disease. However, distant metastases rarely occur. We examined the clinical outcome of patients with antrum neoplasms. Medical records were obtained for all patients diagnosed with a sinus malignancy between July 2009 and January 2014. During this period, 41 patients with maxillary tumours were treated, among which 9 patients received a maxillectomy. There were 21 male and 20 female patients. All patients underwent computed tomography or magnetic resonance imaging. The most common complications were postoperative epistaxis and swallowing difficulty. The treatment of maxillary antrum tumours is complicated and needs advancements to improve early presentation, timely diagnosis, and better management outcomes.

Carcinoma of Maxillary Sinus Masquerading as Odontogenic Infection

Malignant tumours of maxillary sinus are rare. They are usually diagnosed in the late stages when they perforate the sinus walls. The presence of large air space in the maxillary sinus facilitates asymptomatic growth of the sinus malignancy. The clinical presentation of these tumours depends on the sinus wall involved by the disease. The medial wall is usually the first to become eroded, leading to nasal obstruction, epistaxis or discharge. Rarely, symptoms of maxillary sinus carcinoma can resemble dental infection and the affected patients may visit dental clinic seeking treatment. This report presents a case of carcinoma of maxillary sinus mimicking odontogenic infection. Computed tomographic findings explained the reason for the present lesion to masquerade as an inflammatory condition. The importance of advanced imaging modalities for prompt identification of such lesions is discussed.

Spectrum of Sinonasal Tumors: A 10-year Experience at a Tertiary Care Hospital in North India

OBJECTIVE

Sinonasal tumors are a highly heterogeneous group of tumors that account for less than 1% of all cancers. Precise diagnosis is essential because the natural history, treatment, and prognosis vary for different neoplasms. We reviewed 610 cases of sinonasal lesions to understand this entity better.

METHODS

A total of 610 sinonasal biopsies/specimens were received over a period of 10 years (2004-14). All the samples were processed and stained with hematoxylin and eosin. Special staining for microorganisms and immunohistochemistry were performed where indicated.

RESULTS

Benign lesions were 72% with nasal polyp being the most common. Malignant lesions made up 21.2% of lesions with nasopharyngeal carcinoma being the most common while 7.7% cases were inflammatory/non-neoplastic. The most common cause for this was fungal sinusitis. The maxillary sinus was the most frequently involved site in all the lesions (62%). The average age of presentation was 40 years old, and the male to female ratio was 3:1 in those with benign tumors. The average age of presentation in the malignant and inflammatory group were 45 and 43 years, respectively, with an almost equal sex ratio in both categories. Computed tomography and magnetic resonance imaging scans were done in virtually all cases to assess the extent of the tumor as well as bony destruction. Local recurrence was the most frequent cause of treatment failure.

CONCLUSION

Tumors of the nasal cavity are often grouped with those in the paranasal sinuses. Benign tumors constituted approximately 75% of tumors in our hospital. Squamous cell carcinoma was the most common malignancy of this region. These tumors need to be studied closely and accurately because their proximity to vital structures pose significant challenges for their treatment and may be the source of significant patient morbidity.