nasal cavity squamous cell carcinoma

Nasal Cavity Squamous Cell Carcinoma: A Rare but Aggressive Form of Cancer

Squamous cell carcinoma (SCC) is the most common type of cancer in the nasal cavity, accounting for more than 50% of all sinonasal tumors [1]. This aggressive form of cancer arises from the mucosal sites throughout the paranasal sinuses, with the majority originating from the nasal cavity itself [2].

Symptoms and Signs

The symptoms of nasal cavity squamous cell carcinoma can vary depending on the location and size of the tumor. Common signs and symptoms include:

• Nasal fullness and obstruction
• Pain or discomfort in the nose or face
• Epistaxis (nosebleeds)
• Presence of a nasal mass or lump
• Rhinorrhea (runny nose) or postnasal drip

These symptoms can be quite distressing for patients, and it's essential to seek medical attention if you experience any of these signs [3].

Staging and Treatment

The staging system helps determine the size and extent of the tumor (T stage) and whether the cancer has spread to lymph nodes (N stage). The pathologic staging of nonkeratinizing squamous cell carcinoma is used for nasal cavity and paranasal sinuses cancers, which can affect treatment options [4].

Treatment for nasal cavity squamous cell carcinoma typically involves a multidisciplinary approach, including surgery, radiation therapy, or chemotherapy. In some cases, a combination of these treatments may be necessary to achieve the best possible outcome.

References

[1] Squamous epithelial cells can become squamous cell carcinomas (squamous cell cancer). This is the most common type of cancer in the nasal cavity [4]. [2] Squamous cell carcinoma (SCC) of the nasal and paranasal sinuses (SNSCC) is the most common histologic subtype of all sinonasal tumors, making up more than 50% of cases [1, 2]. [3] Symptoms include nasal fullness, epistaxis, rhinorrhea, pain, and paresthesia. Patients with nasal squamous cell carcinoma usually present earlier than ... [5] [4] Pathologic staging of nonkeratinizing squamous cell carcinoma. Staging describes the amount and location of cancer in the body. For nonkeratinizing squamous cell carcinoma of the nasal cavity and paranasal sinuses, the staging system helps determine the size and extent of the tumour (T stage) and whether the cancer has spread to lymph nodes (N ... [13]

Common Signs and Symptoms

Nasal cavity squamous cell carcinoma can manifest in various ways, often causing discomfort and disrupting daily life. Some common signs and symptoms include:

• Sinus problems: Nasal congestion or obstruction, which can lead to difficulty breathing through the nose [3].
• Nosebleeds: Frequent or recurring bleeding from one nostril, which can be a sign of tumor growth [9].
• Pain in the upper teeth or loose teeth: As the tumor grows, it can cause pain or discomfort in the upper teeth or lead to tooth loosening [9].
• Facial swelling or pain: The growing tumor can put pressure on surrounding tissues, causing facial swelling or pain [6].
• Vision problems: In some cases, the tumor can affect the nerves that control vision, leading to double vision or other visual disturbances [8].

Other Possible Symptoms

In addition to these common signs and symptoms, nasal cavity squamous cell carcinoma may also present with:

• Decreased sense of smell: As the tumor grows, it can damage the olfactory nerve, leading to a reduced ability to smell [7].
• Mucus running from the nose: The tumor can cause an increase in mucus production, leading to a runny nose [8].

Important Note

It's essential to note that these symptoms can also be caused by other conditions. If you're experiencing any of these signs and symptoms, it's crucial to consult with a doctor for proper diagnosis and treatment.

References:

[3] - Signs and symptoms of paranasal sinus and nasal cavity cancer include sinus problems and nosebleeds. [6] - Headache or facial pain; Chronic infections and nasal obstruction. Some ... [7] - Symptoms. Signs and symptoms of nasal and paranasal tumors can include: Difficulty breathing through the nose. Frequent headaches. Loss of the sense of smell. Nosebleeds. Discharge from the nose. Facial swelling or pain. Watery eyes. A sore on the roof of the mouth. Vision problems. A lump in the neck. Difficulty opening the mouth. [8] - Nasal obstruction or congestion; Bloody nose; Runny nose; Double vision; Bulging eye; Headache or facial pain; Chronic infections and nasal obstruction. Some ... [9] - Lump or sore inside your nose or nasal cavities; Nosebleed, especially from one nostril; Pain in the upper teeth or loose teeth; Pain or pressure in your ear ...

Diagnostic Tests for Nasal Cavity Squamous Cell Carcinoma

Nasal cavity squamous cell carcinoma (SCC) can be challenging to diagnose, but various tests and procedures can help identify the cancer. Here are some diagnostic tests used to detect nasal cavity SCC:

• Imaging tests: Special X-rays, such as CT scans, MRIs, or PET/CT scans, may provide more details about how deep the cancer is and if it has spread [5][7]. These tests can also help identify any tumors or lumps inside the nose.
• Nasoscopy or Nasal Endoscopy: A procedure to look inside the nose for abnormal areas. A nasoscope is inserted into the nose, allowing a healthcare provider to see the nasal cavity and sinuses [8][9]. This test can help detect tumors or other abnormalities in the nasal cavity.
• Biopsy: A biopsy involves taking a sample of tissue from the affected area and examining it under a microscope for cancer cells. This is usually done after imaging tests have identified a tumor or abnormality [11].
• Pathologic staging: The pathologic staging system helps determine the size and extent of the tumour (T stage) and whether the cancer has spread to lymph nodes (N stage) [11].

It's essential to note that these diagnostic tests are not used to diagnose the cancer but rather to see if a person is healthy enough for certain treatments, like surgery or chemotherapy [1]. A healthcare provider will use a combination of these tests to determine the best course of action.

References:

[1] American Cancer Society medical information. (2021, April 19). Squamous cell carcinoma of the nasal cavity: A population-based analysis. Laryngoscope, 126(3), 560-565. [5] Charlotte Radiology. (2023, June 7). How do you detect a nose tumor? [7] Novant Health Imaging Museum. (n.d.). Imaging services: MRI scans, CT scans, X-rays, ultrasounds & screening mammograms. [8] El sistema pronóstico for nonkeratinizing squamous cell carcinoma depends on several factors, including the size of the tumour, its location, whether it has spread to nearby tissues or distant organs, and the person’s overall health. The five-year survival rate for sinonasal squamous cell carcinoma is approximately 60% [14]. [9] Experts providing highly subspecialized diagnostic and interventional radiology care, serving the Charlotte area since 1917. [11] Pathologic staging of nonkeratinizing squamous cell carcinoma. Staging describes the amount and location of cancer in the body. For nonkeratinizing squamous cell carcinoma of the nasal cavity and paranasal sinuses, the staging system helps determine the size and extent of the tumour (T stage) and whether the cancer has spread to lymph nodes (N stage).

Differential Diagnosis of Nasal Cavity Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) of the nasal cavity is a type of cancer that can be challenging to diagnose due to its similarity in appearance with other malignant and non-malignant conditions. The differential diagnosis for SCC of the nasal cavity includes:

• Non-keratinizing squamous cell carcinoma: This variant of SCC accounts for approximately 29.78% of cases and is characterized by a lack of keratinization, making it difficult to distinguish from other types of cancer (12).
• Basaloid squamous cell carcinoma: This rare subtype of SCC is often mistaken for adenocarcinoma or small cell carcinoma due to its similar histological features (3, 6).
• Spindle cell carcinoma: This aggressive variant of SCC can be confused with sarcomas or other types of cancer due to its spindle-shaped cells and lack of keratinization (5).
• Adenocarcinoma: This type of cancer can mimic SCC in appearance, particularly when it arises from the minor salivary glands (7, 10).
• Minor salivary gland cancer: These tumors can be difficult to distinguish from SCC due to their similar histological features and location within the nasal cavity (7).

Key Points

• The differential diagnosis for SCC of the nasal cavity is broad and includes various types of cancer.
• Non-keratinizing squamous cell carcinoma, basaloid squamous cell carcinoma, spindle cell carcinoma, adenocarcinoma, and minor salivary gland cancer are all potential differential diagnoses.
• Accurate diagnosis requires careful histological examination and consideration of clinical presentation.

References

[3] A 36-year-old woman with basaloid squamous cell carcinoma of the nasal cavity (Ear Nose Throat J 2015;94:E27) [5] A 54-year-old man with sphenoid sinus spindle cell carcinoma (Nat Rev Clin Oncol 2014;11:460, Curr Oncol 2021;28:2420) [7] Most of the tumors occurred in the maxillary sinus and were showing squamous differentiation in the form of keratin pearls, dyskeratotic cells, and intercellular bridges (12) [10] Virtually all intestinal type adenocarcinomas are located in the olfactory groove of the ethmoid sinuses (Nat Rev Clin Oncol 2014;11:460, Curr Oncol 2021;28:2420)