Malignant sinonasal tumor

Sinonasal tumors are uncommon, and those malignant are 0,2 to 0,8% of all tumors and 3% of tumours of the upper aerodigestive tract. Gender distribution with a male predominance of 2 to 1. These lesions are rare before 35 years, but have a higher incidence of sarcomas and carcinomas in the young. Squamous cell carcinoma usually occurs in the fifth to sixth decades of life. Frequency of carcinomas of the ethmoid glandurales in wood workers requires prolonged exposure to wood dust. 80-90% of cases are epithelial tumours of which 30 to 50% are squamous cell carcinomas with topographic preference for the maxillary sinus.

Between 10 and 25% are adenocarcinomas with a preference for the ethmoid. About 10 to 15% are undifferentiated carcinomas with a preferential ethmoidal particularly aggressive clinical course and survival rates are very low. Adenoid cystic carcinomas ranging from 6 to 8%. The most common symptoms are epistaxis, nasal obstruction, rhinorrhea, facial neuralgia, epiphora and dacryocystitis.

Biopsy is mandatory for the differential diagnosis after obtaining reliable imaging and exclude vascular lesions (Figure 1). Surgical treatment by endoscopic sinus surgery should be assessed according to location and histology of the tumor (Video Clip 1) (Video Clip 2) (Video Clip 3).