What Are Nasal Cavity and Paranasal Sinus Cancers?
To understand these cancers, it helps to know a little about the nasal cavity and paranasal sinuses.
The nasal cavity
The nose opens into the nasal passageway, or cavity. This cavity is a space that runs along the top of the roof of the mouth (the palate, which separates your nose from your mouth) and then turns downward to join the passage from the mouth to the throat.
The paranasal sinuses
Sinuses are cavities (spaces) or small tunnels. They are called paranasal because they are around or near the nose. The nasal cavity opens into a network of paired sinuses:
- Maxillary sinuses are in the cheek area, below the eyes on either side of the nose.
- Frontal sinuses are above the inner eye and eyebrow area.
- Sphenoid sinuses are situated deep behind the nose, between the eyes.
- Ethmoid sinuses are made up of many sieve-like sinuses formed of thin bone and mucous tissues. They are above the nose, between the eyes.
Normally, these sinuses are filled with air. When you have a cold or sinus infection the sinuses can become blocked (obstructed) and fill with mucus and pus, which can be uncomfortable.
The nasal cavity and paranasal sinuses have several functions:
- They help filter, warm, and moisten the air you breathe.
- They give your voice resonance.
- They lighten the weight of the skull.
- They provide a bony framework for the face and eyes.
The nasal cavity and the paranasal sinuses are lined by a layer of mucus-producing tissue called mucosa. The mucosa has many types of cells, including:
- Squamous epithelial cells, which are flat cells that line the sinuses and make up most of the mucosa
- Glandular cells such as minor salivary gland cells, which produce mucus and other fluids
- Nerve cells, which are responsible for sensation and the sense of smell in the nose
- Infection-fighting cells (which are part of the immune system), blood vessel cells, and other supporting cells
Other types of cells in the nasal cavity and paranasal sinuses, including bone and cartilage cells, can also become cancerous.
Nasal cavity and paranasal sinus cancers
Any of the cells that make up the mucosa can become cancerous, and each type of cancer behaves or grows differently.
- Squamous epithelial cells can become squamous cell carcinomas. This is the most common type of cancer in the nasal cavity and paranasal sinuses. It makes up a little over half of cancers of these areas.
- Minor salivary gland cells can turn into adenocarcinomas, adenoid cystic carcinomas, and mucoepidermoid cancers. These are the next most frequent type of nasal and paranasal sinus cancers.
- Undifferentiated carcinoma is another type of cancer that can come from mucosa cells. This is a fast-growing cancer in which the cells look so abnormal that it’s hard to tell what type of cell the cancer started in.
- Cells that give the skin its tan or brown color are called melanocytes. These cells give rise to a type of cancer called melanoma. This is typically a cancer that can grow and spread quickly. These cancers usually are found on sun-exposed areas of the skin but can form on the lining of the nasal cavity and sinuses or other areas inside the body.
- Esthesioneuroblastoma is a cancer that starts in the olfactory nerve (the nerve for the sense of smell). This tumor is also known as olfactory neuroblastoma. This type of cancer usually occurs on the roof of the nasal cavity and involves a structure called the cribriform plate. The cribriform plate is a bone deep in the skull, between the eyes, and above the ethmoid sinuses. These tumors can sometimes be mistaken for other types of tumors, like undifferentiated carcinoma or lymphoma.
- Lymphomas (cancers arising from immune system cells called lymphocytes) can also occur in the nasal cavity and paranasal sinuses. One type of lymphoma seen in this area, T-cell/natural killer cell nasal-type lymphoma, was previously called lethal midline granuloma. Information about the diagnosis and treatment of lymphomas can be found in our document Non-Hodgkin Lymphoma.
- Sarcomas are cancers of muscle, bone, cartilage, and fibrous cells that can start anywhere in the body, including the nasal cavity and paranasal sinuses. Information about sarcomas can be found in some of our other documents.
Each of these types of cancer has a distinct behavior and outlook. They cannot all be treated the same way. Many of these cancers rarely affect the nasal cavity and paranasal sinuses, so they have been hard to study thoroughly. Because of this, doctors must base treatment decisions on their experience with similar cancers elsewhere in the head and neck area.
Other growths that can be found in nasal cavity and paranasal sinuses
Some growths in the nasal cavity and paranasal sinuses are not cancers, but they may still cause problems.
Nasal polyps are abnormal growths inside the nasal cavity or paranasal sinuses. Polyps usually have a teardrop shape and tend to have a smooth surface. Most nasal polyps are benign (non-cancerous) and are caused by some type of chronic inflammation in the nose. Using standard exams and tests, doctors can often tell benign polyps from cancer, but in some cases polyps may need to be evaluated more thoroughly to be sure. Small polyps that cause no symptoms may not need treatment, but larger polyps that cause problems may need to be treated with medicine or surgery.
Papillomas are warts that can grow inside the nasal cavity or paranasal sinuses and destroy healthy tissue. They usually have a bumpy surface. Papillomas are not cancer, but sometimes a squamous cell carcinoma will start in a papilloma. Because of the risk of cancer, papillomas in the nasal cavity and paranasal sinuses are removed by surgery.
Inverting papilloma. This is a type of papilloma that is officially classified as a benign tumor, but it tends to act more like a cancer. It has a tendency to recur (come back) and can grow into surrounding tissues. The treatment of inverting papilloma often includes the same type of surgery that is used for cancer.
Last Medical Review: April 22, 2014 Last Revised: August 8, 2016