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. 2019 Apr 19;8(4):539.
doi: 10.3390/jcm8040539.

Metastatic Tumors of the Sinonasal Cavity: A 15-Year Review of 17 Cases

Miao-Hsu Chang  1 , Ying-Ju Kuo  2   3 , Ching-Yin Ho  4   5 , Edward C Kuan  6 , Ming-Ying Lan  7   8
Affiliations

Metastatic Tumors of the Sinonasal Cavity: A 15-Year Review of 17 Cases

Miao-Hsu Chang et al. J Clin Med. .

Abstract

Extranasal cancers that metastasize to the sinonasal cavity are very rare. To date, there are only limited reports regarding this rare condition within the literature. Therefore, we retrospectively reviewed all patients diagnosed with metastatic cancer of the sinonasal tract from 2003 to 2018 at a tertiary academic medical center. Patient demographic data, clinical presentation, treatment modalities, and outcomes were investigated. There were a total of 17 patients (9 males and 8 females) included in the analysis. The mean age was 56.8 years (range 27-80). The most common primary malignancies were hepatocellular carcinoma (n = 3) and gastrointestinal tract adenocarcinoma (n = 3). The most common site of metastasis was the nasal cavity (n = 8). Five patients received radical tumor resection and the others underwent radiotherapy, chemotherapy, or combined chemoradiotherapy. The 2-year survival was 28%. In summary, metastasis to the sinonasal cavity remains extremely rare. A high degree of suspicion regarding the possibility of metastatic spread to the sinonasal region is necessary for patients with a previous history of malignancy who present with new sinonasal symptoms. The treatment strategy of sinonasal metastatic cancer is usually palliative therapy and the prognosis remains poor. However, early detection and diagnosis, coupled with aggressive treatment, may improve patient quality of life.

Keywords: cancer; maxillary sinus; metastases; paranasal sinuses; sinonasal malignancy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Endoscopic views of various sinonasal metastatic cancers. Endoscopic examinations showed various metastatic sinonasal malignancies, which usually appeared as reddish, fragile, and hemorrhagic masses in the nasal cavity or sinuses: (A) retroperitoneum leiomyosarcoma, (B) thyroid poorly differentiated carcinoma, (C) breast invasive ductal carcinoma, (D) rectal adenocarcinoma, (E) hepatic cell carcinoma, and (F) lung adenocarcinoma.
Figure 2
Figure 2
CT and MRI images of sinonasal metastatic cancers: (A) A 37-year-old female diagnosed with metastatic retroperitoneum leiomyosarcoma. The CT scan revealed that the tumor involved the nasal chamber, bilateral sphenoid sinus, left side of the posterior ethmoid sinus, left aspect of the sellar floor, and the clivus. (B) A 45-year-old female diagnosed with retrorectal neuroendocrine carcinoma. The MRI scans revealed that the tumor involved the sphenoid sinus, sella, suprasella, left cavernous sinus, and pituitary gland.
Figure 3
Figure 3
Pathologic images of various sinonasal metastatic cancers: (A) Metastatic neuroendocrine carcinoma; (B) Metastatic colorectal adenocarcinoma of the colon; (C) Metastatic hepatocellular carcinoma; (D) Metastatic papillary thyroid carcinoma; (E) Metastatic breast carcinoma; and (F) Metastatic pulmonary adenocarcinoma.
Figure 4
Figure 4
The overall survival of the 17 patients with sinonasal metastases in our study.
See this image and copyright information in PMC

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