Not all masses or lesions in the nose or sinuses are cancer. In fact, most growths in this area are benign (non-cancerous). There are also some tumours that are on the borderline between benign and malignant (cancerous), so it is best to speak to a doctor about the best treatment for each specific case. In many cases, these growths should be removed with surgery.
Squamous (Schneiderian) Papillomas
These might be related to HPV (human papillomavirus) infections, and they can be found on the front part of the nasal septum (fungiform-type) or on the side nasal wall (inverted and cylindrical types). There is a chance of squamous cell carcinoma within some of these papillomas; therefore, they should be surgically removed.
Other Benign Tumours
- Fibrous dysplasia
- Ossifying fibroma
- Giant cell tumour
- Lobular capillary hemangioma
Some lesions in the nasal and sinus cavities are, in fact, cancerous. The best way to categorise these types of tumours is by the cell type from which the cancer started.
Squamous cell carcinoma
This is the most common type of sinonasal cancer. These cancers arise from the lining of the nasal cavity and sinuses. There are a few different sub-types of squamous cell carcinomas, some more aggressive than others. Examples of these include verrucous squamous cell carcinomas (which have less of a tendency to invade deeply), basaloid squamous cell carcinoma and well-to-poorly differentiated squamous cell carcinomas.
This type of cancer arises from gland-like elements in the lining of the sinonasal tract. Adenocarcinoma is the second most common type of sinonasal cancer.
Minor salivary gland cancers
Minor salivary glands are found within the sinonasal cavity, and they can develop tumours. There are many sub-types of salivary gland tumours (described in more detail in the salivary gland section), but the most common types include:
- Salivary-type adenocarcinoma
- Adenoid cystic carcinoma
- Mucoepidermoid carcinoma
- Acinic cell carcinoma
These cancers arise from melanin skin cells that give skin its colour. In rare cases, melanoma can be found in the lining of the mouth, nose and/or throat. This is called mucosal melanoma. Approximately two-thirds of all mucosal melanomas start out in the nasal cavity and paranasal sinuses (another one-third arise in the oral cavity, and the rest are in various other mucosal sites of the head and neck, such as the throat). These are more aggressive behaving cancers, even when small.
Esthesioneuroblastoma (olfactory neuroblastoma)
This is a rare cancer that arises from the neural cells in the roof of the nose that is responsible for the sense of smell.
Sinonasal undifferentiated carcinoma (SNUC)
This is a rare but very aggressive cancer. It is unclear what the cell of origin is. It often involves multiple different sites and carries a poor prognosis.
Small cell neuroendocrine carcinoma (SNEC)
This is also a rare type of tumour that behaves aggressively and has a poor prognosis.
Non-epithelial-based Sinonasal Cancers
These are soft tissue tumours that arise from different types of tissues, including fibrous tissue, cartilage, bone, muscles and blood vessels, to name a few. Some examples of sarcomas that occur in the sinonasal area include:
- Kaposi’s sarcoma
- Malignant fibrous histiocytoma
- Osteogenic sarcoma
Lymphoid tissue is all over the body, including the nasal cavity and sinuses. Rarely, lymphoma can present as a mass in the sinonasal area.
Tumours that spread from another site
Even more rarely, spread of cancers from other sites could show up in this area. This includes spread of lung, kidney, breast or ovarian cancer.