Understanding a Sinus Tumor

Sinus tumors develop in your nasal cavity and in the open spaces around your nose, which are called the paranasal sinus cavities. They’re the same areas where you often feel pain and pressure when you’re congested or have a sinus headache.

This type of tumor is rare. Less than one-half percent of all diagnosed cancers are cancerous sinus tumors, and not all sinus tumors are cancerous. However, treatment is usually needed because even benign, or noncancerous, tumors can damage your sinuses and nasal cavity.

The majority of sinus tumors develop in the maxillary sinus cavity. This is the sinus area below your cheeks and above your teeth.

Tumors can also develop in your nasal cavity. They can also develop in the sphenoid sinuses that are in the hollow spaces in the bones behind your nose, as well as in the ethmoid sinuses on either side of your nose between the eyes. Only rarely do tumors form behind your ethmoid sinuses or in your frontal sinuses located in the forehead.

The exact cause of the more severe malignant sinus tumors is often unknown, but there are a few proven risk factors. These include:

  • tuxedo. This is one of the most common risk factors for all cancers of the respiratory tract, including sinus tumors.
  • Exposure to certain dust. Breathing in dust from wood, leather, and textiles can increase the risk of cancerous sinus tumors. This strongly impacts people who work in industrial professions.
  • Exposure to certain chemicals. Breathing in vapors from rubbing alcohol, glue, formaldehyde, solvents, nickel, chromium, and radium is linked to a higher risk of cancerous sinus tumors. Much like dust exposure, this is more common for people who work in certain industrial professions.
  • The human papilloma virus (HPV). There’s a link between HPV and cancers in your head and neck, including cancerous sinus tumors.
  • Epstein-Barr virus. Contracting Epstein-Barr virus, which causes mononucleosis, can increase your risk of nasal and sinus cancers.
  • Age. Most people who receive a diagnosis of sinus tumors are in their 50s and 60s.
  • Sex. People assigned male at birth are more likely to receive a diagnosis of sinus tumors. This might be linked to the fact that they are more likely to have other sinus tumor factors. For instance, in the United States, people assigned male at birth are more likely than people assigned female at birth to both smoke and have industrial occupations.

For benign sinus tumors, the symptoms may include:

  • blocked sinuses, leading to difficulty breathing through your nose
  • loss of the sense of smell
  • nosebleeds
  • discharge from your nose
  • facial swelling or pain
  • watery eyes
  • vision problems
  • lumps on your neck
  • difficulty opening your mouth
  • sores or lesions on the roof of your mouth

A sinus tumor doesn’t always mean cancer.

There are multiple types of noncancerous tumors that form in your sinus. Not all of these tumors can spread to other parts of the body, but some can be destructive to the surrounding structures or can even change into something malignant over time.

Though not all of these tumors grow or spread, some can evolve into malignancies. Even if they remain benign, these tumors do need to be treated because they can cause damage to your nasal passages and sinuses, as well as damage to the eyes and base of the skull.

Other tumors that form in your sinuses are cancerous. Types of cancerous tumors that form in your sinuses include:

  • Squamous cell carcinoma. Squamous cell carcinoma is the most common type of cancer in the respiratory tract and sinuses.
  • adenocarcinomas. Adenocarcinomas grow in the lining of sinus cavities.
  • lymphoma. These types of tumors begin in the immune or lymphatic system.
  • sarcomas. This type of cancer forms in bones or soft tissues.
  • Salivary gland cancers. This type of cancer forms in one of the saliva glands found in the sinuses. There are many forms of this cancer, and they’re often graded from low to high grade based on how quickly they may grow and spread.
  • melanoma. Melanomas are aggressive tumors that form in the sinus lining.
  • esthesioneuroblastoma. These tumors develop from nerves at the base of your skull. These rare tumors then grow into your nasal cavity.
  • Sinonasal undifferentiated carcinoma (SNUC). According to a 2004 publication, this is a rare form of cancer in the nasal cavity or paranasal sinuses. Initial symptoms range from a bloody or runny nose, double vision, and bulging eyes to chronic infections and nasal obstruction. SNUC has been associated with several types of benign papilloma in the nasal cavity but can give rise to malignancy.

The signs and symptoms of a sinus tumor can resemble those of a cold, a sinus infection, or allergies when they first appear. Unlike cold or allergy symptoms, symptoms of a nasal tumor won’t be relieved with over-the-counter (OTC) products, and they won’t get better after a week or two.

Symptoms of a sinus tumor include:

  • Blockage on one side of your nose
  • nasal congestion that doesn’t get better
  • postnasal drainage
  • pus and other types of drainage from your nose
  • nosebleeds
  • pain around your eyes
  • pain in your face
  • watery eyes
  • changes in your sense of smell
  • bulging of the eyes
  • vision changes
  • lump or mass on your face, inside your nose, or inside your mouth
  • pain or pressure in your ears
  • changes to your hearing or hearing loss
  • headaches
  • difficulty opening your mouth
  • teeth that feel loose
  • swollen lymph nodes
  • a bulge in the forehead
  • difficulty with eye movements

It’s important to get treatment for any type of sinus tumor. At your appointment, a doctor will go over your medical history and you’ll have a physical exam of your head and neck. They’ll order tests to confirm the diagnosis and to see if the tumor is cancerous.

Tests might include:

  • Sinus endoscopy. A sinus endoscopy involves placing a thin tube with a tiny camera on the end of it carefully into your nasal cavity. The camera takes pictures of your sinus cavities that a medical team will use to look for tumors.
  • Blood work. Blood work can look for elevated levels of certain proteins and blood cells that often indicate cancer.
  • Imaging tests. Imaging tests, such as X-rays and MRIs, create detailed images of your sinuses and can help doctors see the size and location of tumors.
  • biopsy. During a biopsy, a small piece of the tumor will be removed as a chunk of tissue. The tissue sample will then be sent to a lab where it will be analyzed for cancer.

The exact treatment for a sinus tumor depends on where it is located and whether or not it is cancerous.

In cases of benign sinus tumors, treatment for most people is complete removal. Nearly 100 percent of these cases are curable with an endoscopic endonasal approach. Visible skin excisions are often not necessary.

For those sinus tumors determined to be cancerous, nearly all treatment plans will likely include a surgical procedure. While many malignant tumors can be removed endonasally, some may require a combined external approach.

If the tumor is large or in an area where removal will be difficult, you might have radiation treatment first. Radiation treatments can shrink the tumor and make it easier to remove surgically.

Other treatments include:

  • radiation therapy. Radiation therapy might also be given after the tumor is removed to kill additional tumor cells. In some cases, radiation therapy might be the only treatment. This can be done when the person isn’t a good candidate for surgery or doesn’t want to have surgery.
  • chemotherapy. Cancerous sinus tumors that have begun to spread throughout the body sometimes require chemotherapy treatment. Chemotherapy uses strong medications to kill cancer cells.
  • Additional surgery. Sinus tumors can spread to nearby lymph nodes. If this happens, a doctor might recommend surgery to remove those lymph nodes.

Sinus tumors grow in the sinus cavities around your nose. Not all sinus tumors are cancerous, but it’s advised to speak with a medical professional to determine whether any sinus tumor requires treatment. The early symptoms of a sinus tumor can feel like a bad cold, allergies, or a sinus infection, but they won’t get better with rest and OTC medications. It’s best to see a medical professional as soon as possible if you’ve had these symptoms for a few weeks. Early detection can give you more treatment options and can lead to better outcomes.

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