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Paranasal sinus cancer

INTRODUCTION

The paranasal sinuses consist of the maxillary, ethmoid, sphenoid, and frontal sinuses (figure 1). Paranasal sinus cancer is rare; in the United States about 2000 people, mainly aged 45 to 85, develop nasal cavity and paranasal sinus cancer annually [1]. Higher rates are seen in Japan and South Africa. The incidence is higher in males than in females (2:1). Lesions of the maxillary sinus are most common, followed by the ethmoid, sphenoid, and frontal sinuses.

RISK FACTORS

A number of factors have been associated with risk of developing paranasal sinus cancers.

  • Occupational exposures — including leather, textile, and wood dust, and formaldehyde [2-6]

  • Air pollution [7]

  • Tobacco smoke [8]
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References Top
  1. www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_n
    asal_cavity_and_paranasal_cancer.asp?sitearea= (Accessed on March 25, 2008).
  2. 't Mannetje, A, Kogevinas, M, Luce, D, et al. Sinonasal cancer, occupation, and tobacco smoking in European women and men. Am J Ind Med 1999; 36:101.
  3. Bonneterre, V, Deschamps, E, Persoons, R, et al. Sino-nasal cancer and exposure to leather dust. Occup Med (Lond) 2007; 57:438.
  4. Battista, G, Comba, P, Orsi, D, et al. Nasal cancer in leather workers: an occupational disease. J Cancer Res Clin Oncol 1995; 121:1.
  5. Luce, D, Gerin, M, Morcet, JF, Leclerc, A. Sinonasal cancer and occupational exposure to textile dust. Am J Ind Med 1997; 32:205.
  6. Luce, D, Leclerc, A, Begin, D, et al. Sinonasal cancer and occupational exposures: a pooled analysis of 12 case-control studies. Cancer Causes Control 2002; 13:147.
  7. Calderon-Garciduenas, L, Delgado, R, Calderon-Garciduenas, A, et al. Malignant neoplasms of the nasal cavity and paranasal sinuses: a series of 256 patients in Mexico City and Monterrey. Is air pollution the missing link?. Otolaryngol Head Neck Surg 2000; 122:499.
  8. Zheng, W, McLaughlin, JK, Chow, WH, et al. Risk factors for cancers of the nasal cavity and paranasal sinuses among white men in the United States. Am J Epidemiol 1993; 138:965.
  9. Kim, JY, Yoon, JK, Citardi, MJ, et al. The prevalence of human papilloma virus infection in sinonasal inverted papilloma specimens classified by histological grade. Am J Rhinol 2007; 21:664.
  10. Alos, L, Moyano, S, Nadal, A, et al. Human papillomaviruses are identified in a subgroup of sinonasal squamous cell carcinomas with favorable outcome. Cancer 2009; 115:2701.
  11. Feng, YF, Wu, QL, Zong, YS. Correlation of immunophenotype of sinonasal non-Hodgkin's lymphoma to Epstein-Barr virus infection. Ai Zheng 2007; 26:1170.
  12. Mitarnun, W, Suwiwat, S, Pradutkanchana, J. Epstein-Barr virus-associated extranodal non-Hodgkin's lymphoma of the sinonasal tract and nasopharynx in Thailand. Asian Pac J Cancer Prev 2006; 7:91.
  13. Tufano, RP, Mokadam, NA, Montone, KT, et al. Malignant tumors of the nose and paranasal sinuses: hospital of the University of Pennsylvania experience 1990-1997. Am J Rhinol 1999; 13:117.
  14. Cantu, G, Bimbi, G, Miceli, R, et al. Lymph node metastases in malignant tumors of the paranasal sinuses: prognostic value and treatment. Arch Otolaryngol Head Neck Surg 2008; 134:170.
  15. Myers, LL, Nussenbaum, B, Bradford, CR, et al. Paranasal sinus malignancies: an 18-year single institution experience. Laryngoscope 2002; 112:1964.
  16. Guntinas-Lichius, O, Kreppel, MP, Stuetzer, H, et al. Single modality and multimodality treatment of nasal and paranasal sinuses cancer: a single institution experience of 229 patients. Eur J Surg Oncol 2007; 33:222.
  17. Blanco, AI, Chao, KS, Ozyigit, G, et al. Carcinoma of paranasal sinuses: long-term outcomes with radiotherapy. Int J Radiat Oncol Biol Phys 2004; 59:51.
  18. Harbo, G, Grau, C, Bundgaard, T, et al. Cancer of the nasal cavity and paranasal sinuses. A clinico-pathological study of 277 patients. Acta Oncol 1997; 36:45.
  19. Chen, AM, Daly, ME, Bucci, MK, et al. Carcinomas of the paranasal sinuses and nasal cavity treated with radiotherapy at a single institution over five decades: are we making improvement?. Int J Radiat Oncol Biol Phys 2007; 69:141.
  20. Cummings Otolaryngology-Head and Neck Surgery, 4th ed. Cummings, CW Jr, Haughey, BH, Thomas, JR, et al (Eds), Mosby, St Louis 2004.
  21. Comprehensive Management of Head and Neck Tumors, 2nd ed, Thawley, SE, Panje, WR, Batsakis, JG, et al (Eds), WB Saunders, Philadelphia 1999.
  22. Loevner, LA, Sonners, AI. Imaging of neoplasms of the paranasal sinuses. Neuroimaging Clin N Am 2004; 14:625.
  23. Das, S, Kirsch, CF. Imaging of lumps and bumps in the nose: a review of sinonasal tumours. Cancer Imaging 2005; 5:167.
  24. AJCC (American Joint Committee on Cancer) Cancer Staging Manual, 6th ed, Greene, FL, Page, DL, Fleming, ID, et al (Eds), Springer-Verlag, New York 2002. p.61.
  25. Dulguerov, P, Jacobsen, MS, Allal, AS, et al. Nasal and paranasal sinus carcinoma: are we making progress? A series of 220 patients and a systematic review. Cancer 2001; 92:3012.
  26. Bogaerts, S, Vander, Poorten V, Nuyts, S, et al. Results of endoscopic resection followed by radiotherapy for primarily diagnosed adenocarcinomas of the paranasal sinuses. Head Neck 2008; 30:728.
  27. Jansen, EP, Keus, RB, Hilgers, FJ. Does the combination of radiotherapy and debulking surgery favor survival in paranasal sinus carcinoma?. Int J Radiat Oncol Biol Phys 2000; 48:27.
  28. Howard, DJ, Lund, VJ, Wei, WI. Craniofacial resection for tumors of the nasal cavity and paranasal sinuses: a 25-year experience. Head Neck 2006; 28:867.
  29. Vrionis, FD, Kienstra, MA, Rivera, M, Padhya, TA. Malignant tumors of the anterior skull base. Cancer Control 2004; 11:144.
  30. Ganly, I, Patel, SG, Singh, B, et al. Craniofacial resection for malignant paranasal sinus tumors: Report of an International Collaborative Study. Head Neck 2005; 27:575.
  31. Porceddu, S, Martin, J, Shanker, G, et al. Paranasal sinus tumors: Peter MacCallum Cancer Institute experience. Head Neck 2004; 26:322.
  32. Kellman, RM, Marentette, L. The transglabellar/subcranial approach to the anterior skull base: a review of 72 cases. Arch Otolaryngol Head Neck Surg 2001; 127:687.
  33. Moore, CE, Ross, DA, Marentette, LJ. Subcranial approach to tumors of the anterior cranial base: analysis of current and traditional surgical techniques. Otolaryngol Head Neck Surg 1999; 120:387.
  34. Jesse, RH, Butler, JJ, Healey, JE, et al. Paranasal sinuses and nasal cavity. In: Cancer of the head and neck, MacComb, WS, Fletcher, GH, (Eds), Williams & Wilkins, Baltimore 1967. p.329.
  35. McKay, SP, Shibuya, TY, Armstrong, WB, et al. Cell carcinoma of the paranasal sinuses and skull base. Am J Otolaryngol 2007; 28:294.
  36. Solero, CL, DiMeco, F, Sampath, P, et al. Combined anterior craniofacial resection for tumors involving the cribriform plate: early postoperative complications and technical considerations. Neurosurgery 2000; 47:1296.
  37. Janecka, IP, Sen, C, Sekhar, LN, et al. Cranial base surgery: results in 183 patients. Otolaryngol Head Neck Surg 1994; 110:539.
  38. Ganly, I, Patel, SG, Singh, B, et al. Complications of craniofacial resection for malignant tumors of the skull base: report of an International Collaborative Study. Head Neck 2005; 27:445.
  39. Ganly, I, Gross, ND, Patel, SG, et al. Outcome of craniofacial resection in patients 70 years of age and older. Head Neck 2007; 29:89.
  40. Futran, ND, Mendez, E. Developments in reconstruction of midface and maxilla. Lancet Oncol 2006; 7:249.
  41. Cordeiro, PG, Santamaria, E, Kraus, DH, et al. Reconstruction of total maxillectomy defects with preservation of the orbital contents. Plast Reconstr Surg 1998; 102:1874.
  42. Genden, EM, Okay, D, Stepp, MT, et al. Comparison of functional and quality-of-life outcomes in patients with and without palatomaxillary reconstruction: a preliminary report. Arch Otolaryngol Head Neck Surg 2003; 129:775.
  43. Tiwari, R, van der, Wal J, van der, Waal I, Snow, G. Studies of the anatomy and pathology of the orbit in carcinoma of the maxillary sinus and their impact on preservation of the eye in maxillectomy. Head Neck 1998; 20:193.
  44. Van Tuyl, R, Gussack, GS. Prognostic factors in craniofacial surgery. Laryngoscope 1991; 101:240.
  45. McCaffrey, TV, Olsen, KD, Yohanan, JM, et al. Factors affecting survival of patients with tumors of the anterior skull base. Laryngoscope 1994; 104:940.
  46. Carrau, RL, Segas, J, Nuss, DW, et al. Squamous cell carcinoma of the sinonasal tract invading the orbit. Laryngoscope 1999; 109:230.
  47. Imola, MJ, Schramm, VL Jr. Orbital preservation in surgical management of sinonasal malignancy. Laryngoscope 2002; 112:1357.
  48. Essig, GF, Newman, SA, Levine, PA. Sparing the eye in craniofacial surgery for superior nasal vault malignant neoplasms: analysis of benefit. Arch Facial Plast Surg 2007; 9:406.
  49. Goffart, Y, Jorissen, M, Daele, J, et al. Minimally invasive endoscopic management of malignant sinonasal tumours. Acta Otorhinolaryngol Belg 2000; 54:221.
  50. Roh, HJ, Batra, PS, Citardi, MJ, et al. Endoscopic resection of sinonasal malignancies: a preliminary report. Am J Rhinol 2004; 18:239.
  51. Batra, PS, Citardi, MJ, Worley, S, et al. Resection of anterior skull base tumors: comparison of combined traditional and endoscopic techniques. Am J Rhinol 2005; 19:521.
  52. Parsons, JT, Mendenhall, WM, Mancuso, AA, et al. Malignant tumors of the nasal cavity and ethmoid and sphenoid sinuses. Int J Radiat Oncol Biol Phys 1988; 14:11.
  53. Waldron, JN, O'Sullivan, B, Warde, P, et al. Ethmoid sinus cancer: twenty-nine cases managed with primary radiation therapy. Int J Radiat Oncol Biol Phys 1998; 41:361.
  54. Vedrine, PO, Thariat, J, Merrot, O, et al. Primary cancer of the sphenoid sinus--a GETTEC study. Head Neck 2009; 31:388.
  55. Katz, TS, Mendenhall, WM, Morris, CG, et al. Malignant tumors of the nasal cavity and paranasal sinuses. Head Neck 2002; 24:821.
  56. Parsons, JT, Kimsey, FC, Mendenhall, WM, et al. Radiation therapy for sinus malignancies. Otolaryngol Clin North Am 1995; 28:1259.
  57. Brizel, DM, Light, K, Zhou, SM, Marks, LB. Conformal radiation therapy treatment planning reduces the dose to the optic structures for patients with tumors of the paranasal sinuses. Radiother Oncol 1999; 51:215.
  58. Hoppe, BS, Nelson, CJ, Gomez, DR, et al. Unresectable Carcinoma of the Paranasal Sinuses: Outcomes and Toxicities. Int J Radiat Oncol Biol Phys 2008; 72:763.
  59. National Comprehensive Cancer Network (NCCN) guidelines available online at http://www.nccn.org/professionals/physician_gls/f_guidelines.asp (Accessed May 12, 2009).
  60. Hoppe, BS, Stegman, LD, Zelefsky, MJ, et al. Treatment of nasal cavity and paranasal sinus cancer with modern radiotherapy techniques in the postoperative setting-the MSKCC experience. Int J Radiat Oncol Biol Phys 2007; 67:691.
  61. Sisson, GA, Sr, Toriumi, DM, Atiyah, RA. Paranasal sinus malignancy: a comprehensive update. Laryngoscope 1989; 99:143.
  62. Bjork-Eriksson, T, Mercke, C, Petruson, B, Ekholm, S. Potential impact on tumor control and organ preservation with cisplatin and 5-fluorouracil for patients with advanced tumors of the paranasal sinuses and nasal fossa. A prospective pilot study. Cancer 1992; 70:2615.
  63. Dirix, P, Nuyts, S, Geussens, Y, et al. Malignancies of the nasal cavity and paranasal sinuses: long-term outcome with conventional or three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys 2007; 69:1042.
  64. Bristol, IJ, Ahamad, A, Garden, AS, et al. Postoperative radiotherapy for maxillary sinus cancer: long-term outcomes and toxicities of treatment. Int J Radiat Oncol Biol Phys 2007; 68:719.
  65. Duthoy, W, Boterberg, T, Claus, F, et al. Postoperative intensity-modulated radiotherapy in sinonasal carcinoma: clinical results in 39 patients. Cancer 2005; 104:71.
  66. Daly, ME, Chen, AM, Bucci, MK, et al. Intensity-modulated radiation therapy for malignancies of the nasal cavity and paranasal sinuses. Int J Radiat Oncol Biol Phys 2007; 67:151.
  67. Lomax, AJ, Goitein, M, Adams, J. Intensity modulation in radiotherapy: photons versus protons in the paranasal sinus. Radiother Oncol 2003; 66:11.
  68. Resto, VA, Chan, AW, Deschler, DG, Lin, DT. Extent of surgery in the management of locally advanced sinonasal malignancies. Head Neck 2008; 30:222.
  69. DeLaney, TF. Clinical proton radiation therapy research at the Francis H. Burr Proton Therapy Center. Technol Cancer Res Treat 2007; 6:61.
  70. Weber, DC, Chan, AW, Lessell, S, et al. Visual outcome of accelerated fractionated radiation for advanced sinonasal malignancies employing photons/protons. Radiother Oncol 2006; 81:243.
  71. Dulguerov, P, Allal, AS. Nasal and paranasal sinus carcinoma: how can we continue to make progress?. Curr Opin Otolaryngol Head Neck Surg 2006; 14:67.
  72. Mock, U, Georg, D, Bogner, J, et al. Treatment planning comparison of conventional, 3D conformal, and intensity-modulated photon (IMRT) and proton therapy for paranasal sinus carcinoma. Int J Radiat Oncol Biol Phys 2004; 58:147.
  73. Choi, KN, Rotman, M, Aziz, H, et al. Concomitant infusion cisplatin and hyperfractionated radiotherapy for locally advanced nasopharyngeal and paranasal sinus tumors. Int J Radiat Oncol Biol Phys 1997; 39:823.
  74. Monroe, AT, Bhandare, N, Morris, CG, Mendenhall, WM. Preventing radiation retinopathy with hyperfractionation. Int J Radiat Oncol Biol Phys 2005; 61:856.
  75. Snyers, A, Janssens, GO, Twickler, MB, et al. Malignant tumors of the nasal cavity and paranasal sinuses: long-term outcome and morbidity with emphasis on hypothalamic-pituitary deficiency. Int J Radiat Oncol Biol Phys 2009; 73:1343.
  76. Jeremic, B, Nguyen-Tan, F, Bamberg, M. Elective neck irradiation in locally advanced squamous cell carcinoma of the maxillary sinus: a review. J Cancer Res Clin Oncol 2002; 128:235.
  77. Kondo, M, Ogawa, K, Inuyama, Y, et al. Prognostic factors influencing relapse of squamous cell carcinoma of the maxillary sinus. Cancer 1985; 55:190.
  78. Paulino, AC, Fisher, SG, Marks, JE. Is prophylactic neck irradiation indicated in patients with squamous cell carcinoma of the maxillary sinus?. Int J Radiat Oncol Biol Phys 1997; 39:283.
  79. Licitra, L, Locati, LD, Cavina, R, et al. Primary chemotherapy followed by anterior craniofacial resection and radiotherapy for paranasal cancer. Ann Oncol 2003; 14:367.
  80. Lee, MM, Vokes, EE, Rosen, A, et al. Multimodality therapy in advanced paranasal sinus carcinoma: superior long-term results. Cancer J Sci Am 1999; 5:219.
  81. Samant, S, Robbins, KT, Vang, M, et al. Intra-arterial cisplatin and concomitant radiation therapy followed by surgery for advanced paranasal sinus cancer. Arch Otolaryngol Head Neck Surg 2004; 130:948.
  82. Harrison, LB, Raben, A, Pfister, DG, et al. A prospective phase II trial of concomitant chemotherapy and radiotherapy with delayed accelerated fractionation in unresectable tumors of the head and neck. Head Neck 1998; 20:497.
  83. Brasnu, D, Laccourreye, O, Bassot, V, et al. Cisplatin-based neoadjuvant chemotherapy and combined resection for ethmoid sinus adenocarcinoma reaching and/or invading the skull base. Arch Otolaryngol Head Neck Surg 1996; 122:765.
  84. Yoshimura, R, Shibuya, H, Ogura, I, et al. Trimodal combination therapy for maxillary sinus carcinoma. Int J Radiat Oncol Biol Phys 2002; 53:656.
  85. Nishino, H, Miyata, M, Morita, M, et al. Combined therapy with conservative surgery, radiotherapy, and regional chemotherapy for maxillary sinus carcinoma. Cancer 2000; 89:1925.
  86. Roux, FX, Brasnu, D, Devaux, B, et al. Ethmoid sinus carcinomas: results and prognosis after neoadjuvant chemotherapy and combined surgery--a 10-year experience. Surg Neurol 1994; 42:98.
  87. Wiseman, SM, Popat, SR, Rigual, NR, et al. Adenoid cystic carcinoma of the paranasal sinuses or nasal cavity: a 40-year review of 35 cases. Ear Nose Throat J 2002; 81:510.
  88. Polin, RS, Sheehan, JP, Chenelle, AG, et al. The role of preoperative adjuvant treatment in the management of esthesioneuroblastoma: the University of Virginia experience. Neurosurgery 1998; 42:1029.
  89. Gruber, G, Laedrach, K, Baumert, B, et al. Esthesioneuroblastoma: irradiation alone and surgery alone are not enough. Int J Radiat Oncol Biol Phys 2002; 54:486.
  90. Constantinidis, J, Steinhart, H, Koch, M, et al. Olfactory neuroblastoma: the University of Erlangen-Nuremberg experience 1975-2000. Otolaryngol Head Neck Surg 2004; 130:567.
  91. Monroe, AT, Hinerman, RW, Amdur, RJ, et al. Radiation therapy for esthesioneuroblastoma: rationale for elective neck irradiation. Head Neck 2003; 25:529.
  92. Mendenhall, WM, Hinerman, RW, Malyapa, RS, et al. Inverted papilloma of the nasal cavity and paranasal sinuses. Am J Clin Oncol 2007; 30:560.
  93. Melroy, CT, Senior, BA. Benign sinonasal neoplasms: a focus on inverting papilloma. Otolaryngol Clin North Am 2006; 39:601.
  94. Lawson, W, Patel, ZM. The evolution of management for inverted papilloma: An analysis of 200 cases. Otolaryngol Head Neck Surg 2009; 140:330.
  95. Proulx, GM, Caudra-Garcia I, Ferry J, et al. Lymphoma of the nasal cavity and paranasal sinuses: treatment and outcome of early-stage disease. Am J Clin Oncol 2003; 26:6.
  96. Hausdorff, J, Davis, E, Long, G, et al. Non-Hodgkin's lymphoma of the paranasal sinuses: clinical and pathological features, and response to combined-modality therapy. Cancer J Sci Am 1997; 3:303.
  97. Logsdon, MD, Ha, CS, Kavadi, VS, et al. Lymphoma of the nasal cavity and paranasal sinuses: improved outcome and altered prognostic factors with combined modality therapy. Cancer 1997; 80:477.
  98. Laskin, JJ, Savage, KJ, Voss, N, et al. Primary paranasal sinus lymphoma: natural history and improved outcome with central nervous system chemoprophylaxis. Leuk Lymphoma 2005; 46:1721.
  99. Thompson, LD, Wieneke, JA, Miettinen, M. Sinonasal tract and nasopharyngeal melanomas: a clinicopathologic study of 115 cases with a proposed staging system. Am J Surg Pathol 2003; 27:594.
  100. Enepekides, DJ. Sinonasal undifferentiated carcinoma: an update. Curr Opin Otolaryngol Head Neck Surg 2005; 13:222.
  101. Mendenhall, WM, Mendenhall, CM, Riggs, CE Jr, et al. Sinonasal undifferentiated carcinoma. Am J Clin Oncol 2006; 29:27.
  102. Rischin, D, Porceddu, S, Peters, L, et al. Promising results with chemoradiation in patients with sinonasal undifferentiated carcinoma. Head Neck 2004; 26:435.
  103. Chen, AM, Daly, ME, El-Sayed, I, et al. Patterns of failure after combined-modality approaches incorporating radiotherapy for sinonasal undifferentiated carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 2008; 70:338.
  104. Bhattacharyya, N. Factors affecting survival in maxillary sinus cancer. J Oral Maxillofac Surg 2003; 61:1016.
  105. Alvarez, I, Suarez, C, Rodrigo, JP, et al. Prognostic factors in paranasal sinus cancer. Am J Otolaryngol 1995; 16:109.
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