Title: Clinico- histopathological study of sinonasal malignant tumours- A 5 years experience at a tertiary cancer institute

Authors: Dr Rajjyoti Das, Dr Anupam Sarma, Dr Jagannath Dev Sharma, Dr Dhaneswor Singh, Dr Tashnin Rahman, Dr Amal Chandra Kataki

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.56

Abstract

Sinonasal malignancies (SNM) are rare (0.2 -0.8 %) but aggressive tumours. These tumors are usually diagnosed at an advance stage, as symptoms are nonspecific and mimic common ailments. The complex and difficult-to-access anatomy of the paranasal sinuses, its intimate relation with the orbit and brain, and the presence of multiple natural pathways promoting early tumour-spread add up to the practical challenges faced by oncologist. This retrospective study was done to study the spectrum of different sinonasal malignancies, their clinical presentation and histo-pathological characteristics in patients presenting in our institute in last 5 years.

Result: In our study of 81 patients (median age of 51+/-12 years, M:F = 1.6: 1) the  commonest presenting symptoms were blood stained nasal discharge (85%) and unilateral nose block (71%). Commonest primary site was Maxillary sinus (52%). Squamous cell carcinoma was the commonest malignancy (40%). Small round cell tumors (SRCT) comprised a significant 34% of outpatients (n=28). Immunohistochemical evaluation of these SRCTs derived the final diagnosis as SNUC (n=8), Lymphoma (n=6), PDSCC (n=4) and Melanoma (n=3) among others.

Conclusion: Sinonasal malignant tumours are aggressive in nature. Immunohistochemistry plays an important role in proper histopathological diagnosis and further treatment planning. However, further prospective studies are required to understand the spectrum and clinical behaviour of these tumours.

Keywords: Sinonasal tumour, undifferentiated carcinoma, Lymphoma, Small round cell tumours, Immunohistochemistry.

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Corresponding Author

Dr Anupam Sarma; MD

Professor Department of Pathology, Dr. B.Borooah Cancer Institute, Guwahati, Assam, India