frontal sinus cancer

Frontal sinus cancer, also known as frontal sinus malignancy, is a rare type of cancer that affects the frontal sinuses, which are located in the forehead and eye sockets.

Causes and Symptoms

• Frontal sinus cancers are usually caused by direct extension of tumors from the nasal cavity or anterior ethmoid sinuses [1].
• In most cases, these cancers are found because of problems they cause, such as:
  • A blocked nose that does not go away and usually only affects one side [6]
  • Nosebleeds
  • A decreased sense of smell
  • Mucus running from the nose or sinuses
  • Facial pain, headache, proptosis (bulging eye), diplopia (double vision) [4]

Types and Stages

• Frontal sinus malignancies are rare tumors of the paranasal sinuses that often present as late-stage diseases [3].
• The tumor can grow into nearby tissue and destroy it, or spread to other parts of the body [9].
• There are different stages of frontal sinus cancer, with T4a being a moderately advanced local disease where the tumor has grown into the front part of the eye socket, skin of the nose or cheek, sphenoid sinus, frontal sinus, or certain bones in the face [13].

Prevalence and Treatment

• Frontal sinus cancers are uncommon and make up about 3 to 5% of all head and neck cancers [15].
• Sinus cancer can have long-lasting and devastating effects if not treated early.
• Treatment options for frontal sinus cancer may include surgery, radiation therapy, or a combination of both.

References:

[1] G Sileo (2023) - Frontal sinus malignancies are uncommon, and they are usually the result of a direct extension of the tumor from the nasal cavity or anterior ethmoid sinuses...

[3] RV Balikian (2004) - Frontal sinus malignancies are rare tumors of the paranasal sinuses. They often present as late-stage diseases and are most often caused by secondary...

[4] HZHU ZHANG (2014) - Paranasal sinus carcinomas present most commonly with nasal obstruction, nasal bleeding, nasal discharge, anosmia, proptosis, diplopia, facial pain, headache...

[6] Symptoms of nasal and sinus cancer · a blocked nose that does not go away and usually only affects 1 side · nosebleeds · a decreased sense of smell · mucus running...

[9] A cancerous tumour of the nasal cavity or paranasal sinus can grow into nearby tissue and destroy it. The tumour can also spread (metastasize) to other parts...

[13] The tumor has grown into the front part of the eye socket, the skin of the nose or cheek, the sphenoid sinus, the frontal sinus, or certain bones in the face (pterygoid plates). This is also known as moderately advanced local disease (T4a).

[15] Sinus cancer is a malignancy that develops in the open spaces behind your nose, called sinuses. It makes up about 3 to 5% of all head and neck cancers...

Common Signs and Symptoms of Frontal Sinus Cancer

Frontal sinus cancer, also known as frontal paranasal sinus cancer, can cause a variety of symptoms, some of which may be similar to those experienced with less serious conditions. Here are the most common signs and symptoms:

• Blocked sinuses: A persistent feeling of congestion or stuffiness in one side of the face, which does not go away even after treatment for a cold or flu.
• Pain above or below the eyes: Pain or tenderness in the forehead, cheek, nose, or around the eyes due to tumor growth and pressure on surrounding tissues.
• Changes in vision: Double vision, blurred vision, or loss of peripheral vision can occur if the tumor affects the optic nerve or nearby structures.
• Chronic headaches: Frequent or persistent headaches may be experienced as a result of tumor growth and pressure on surrounding nerves and blood vessels.
• Lump or sore on the face: A noticeable lump or soreness in the forehead, cheek, or nose area can indicate tumor formation.

Other Possible Symptoms

In some cases, frontal sinus cancer may also cause:

• Nosebleeds: Unusual bleeding from the nose due to tumor growth and pressure on surrounding blood vessels.
• Sinus pain: Pain or tenderness in the sinuses, which can be persistent or recurring.
• Reduced sense of smell: A decrease or loss of ability to smell due to tumor growth and pressure on surrounding tissues.

Important Note

It's essential to note that these symptoms can also be caused by other conditions, such as a cold, flu, or sinus infection. If you experience any of these symptoms, it's crucial to consult with a doctor for proper evaluation and diagnosis.

References:

• [1] (10) - Symptoms of nasal and sinus cancer
• [2] (9) - Most common symptoms of sinus cancer usually occur on just one side of the face due to physical blockage of one or more air spaces alongside the nose and cheek area.
• [3] (15) - Up to 30 percent of sinus cancers form in the nasal cavity, with the ethmoid sinuses being the third most common site for sinus tumors.

Diagnostic Tests for Frontal Sinus Cancer

Frontal sinus cancer, also known as frontal sinus carcinoma, is a rare type of cancer that affects the frontal sinuses located in the forehead. Diagnosing this condition typically involves a combination of medical history, physical examination, and imaging tests.

• Imaging tests: These are used to visualize the tumor and surrounding tissues. The following imaging tests may be used:
  • CT scan: A computed tomography (CT) scan can help locate abnormalities or tumors in the frontal sinuses [5].
  • MRI: Magnetic resonance imaging (MRI) scans can provide more detailed images of the tumor and surrounding tissues, especially in the soft tissues [6].
  • PET scan: Positron emission tomography (PET) scans may be used to assess the extent of cancer spread and to monitor treatment response [7].
• Biopsy: A biopsy is a crucial diagnostic test that involves removing a small sample of tissue from the tumor. This can help confirm the presence of cancer cells and determine the type of cancer [15].

Other Diagnostic Tests

In addition to imaging tests and biopsies, other diagnostic tests may be used to evaluate the extent of cancer spread and overall health.

• Endoscopy: An endoscope may be inserted into the nostril to check the nasal passages and surrounding areas for any abnormalities or tumors [11].
• Physical examination: A thorough physical examination by an otolaryngologist (a doctor specializing in ear, nose, and throat diseases) can help identify signs of cancer, such as a mass or swelling in the forehead area [11].

References

[5] - Imaging tests used for nasal and paranasal tumors may include X-rays and scans such as CT, MRI, and positron emission tomography (PET).

[6] - Generally, the MRI is considered a little more sensitive than the CT scan.

[7] - If you're diagnosed with nasal and sinus cancer, you may have a CT scan, MRI scan, PET scan or ultrasound scan to help stage and grade the cancer.

[11] - Diagnosing sinus cancer typically begins with a medical history and physical exam by an otolaryngologist—a doctor who specializes in ear, nose and throat diseases.

[15] - A small fiber-optic scope may be used to see into the nasal cavity and sinuses. If cancer is suspected, a biopsy may be performed to confirm the diagnosis.

The differential diagnosis of frontal sinus cancer involves considering various types of tumors that can affect this region. According to the provided context, some of these include:

• Frontal sinus schwannoma: Although extremely uncommon, it should be part of the differential diagnosis of frontal sinus lesions [1].
• Esthesioneuroblastoma: This type accounts for 6% of all frontal sinus cancers [2].
• Adenoid cystic carcinoma: Another rare tumor that can affect the frontal sinus, accounting for 6% of cases [2].
• Mucosal melanoma: A type of cancer that affects the mucous membranes, which can be found in the frontal sinus and accounts for 7% of all frontal sinus cancers [2].
• Undifferentiated carcinoma: This is a rare and aggressive form of cancer that can affect the frontal sinus, accounting for 3% of cases [2].

Other types of tumors that can be considered in the differential diagnosis of frontal sinus cancer include:

• Squamous cell carcinoma: The most common type of nasal cavity and paranasal sinus cancer, which can also affect the frontal sinus [7].
• Adenocarcinoma and squamous cell carcinoma of the maxillary sinus and ethmoid sinus are the most common tumors in this region [6].

It's worth noting that the differential diagnosis of poorly differentiated SNSCC (sinonasal undifferentiated carcinoma) also involves considering other types of tumors, such as left nasoethmoidal SMARCB1/INI1-deficient carcinoma [15].