Sinonasal Carcinoma

What is a Sinonasal Carcinoma?

Overview

Sinonasal carcinomas are rare cancers that develop in the nasal sinuses and skull base region. They can include several types, such as sinonasal undifferentiated carcinoma (SNUC), squamous cell carcinoma, giant cell tumors, neuroendocrine tumors, mucoepidermoid carcinomas, and lymphomas.

Treatment typically involves maximal surgical removal, often followed by radiation therapy and, in some cases, chemotherapy. In some situations, a biopsy followed by radiation and chemotherapy may be recommended instead. Fortunately, most of these cancers can be treated using a minimally invasive endoscopic endonasal approach, allowing surgeons to access and remove tumors through the nose without external incisions, leading to faster recovery and fewer complications.

These tumors are often locally invasive, meaning they may extend into nearby structures such as the nasal cavity, orbits (eye sockets), and skull base, involving areas like the cavernous sinus, Meckel’s cave, sella, clivus, and cribriform plate. In rare cases, larger or more aggressive tumors can affect the brain and cranial nerves.

Early diagnosis and expert treatment are key. With advances in endoscopic skull base surgery and multidisciplinary cancer care, many patients can achieve excellent outcomes and maintain a good quality of life.

Who is Affected?

Sinonasal carcinomas can affect adults of any age, but they are most commonly diagnosed in individuals between 40 and 70 years old. Certain risk factors, such as tobacco use, occupational exposures to wood dust, leather dust, or industrial chemicals, and a history of chronic sinus inflammation, may increase the risk of developing these tumors. Both men and women can be affected, though some types of sinonasal carcinomas are more frequent in men.

Sinonasal Carcinoma Symptoms & Causes

Symptoms

Sinonasal carcinomas often cause symptoms that can mimic more common sinus conditions, which may delay diagnosis. Tumors that grow into the sellar/pituitary region may cause symptoms of pituitary failure (Hypopituitarism).

Key symptoms include:

• Epistaxis (nasal bleeding)
• Facial pain or pressure
• Headache
• Nasal obstruction or congestion
• Double vision or facial numbness (if the cavernous sinus is involved)
• Changes in smell or vision
• Pituitary hormone symptoms (such as fatigue, weight changes, or menstrual irregularities) if the tumor grows into the sellar/pituitary region

Causes

The exact cause of sinonasal carcinoma is not fully understood. However, risk factors include:

• Environmental and occupational exposures: Long-term exposure to wood dust, leather dust, textile fibers, nickel, and chromium
• Smoking: Tobacco use increases the risk of some sinonasal cancers
• Chronic sinus inflammation or infection
• Human papillomavirus (HPV): Some sinonasal carcinomas are associated with HPV infection
• Genetic changes: DNA mutations may lead to abnormal cell growth in the nasal cavity or sinuses

When to See a Doctor

Early evaluation by an ENT specialist or neurosurgeon is critical for timely diagnosis and treatment. You should seek medical attention if you experience:

• Unexplained or recurrent nosebleeds
• Persistent sinus pain or pressure that doesn’t improve with treatment
• Facial numbness, swelling, or vision changes
• Headaches that worsen over time
• New hormonal changes (such as unexplained fatigue, libido changes, or menstrual irregularities)

Sinonasal Carcinoma Diagnosis

Sinonasal carcinomas are typically diagnosed with imaging studies such as:

Magnetic Resonance Imaging (MRI)

Provides detailed images of the tumor’s size, extent, and involvement of nearby structures like the skull base or orbit.

Computed Tomography (CT) Scan

Helps assess bone involvement and tumor extension.

Endoscopic Biopsy

A tissue sample is obtained via a minimally invasive approach to confirm the diagnosis.

Sinonasal Carcinoma Treatmentrn& Outcomes

Treatment Options

Treatment for sinonasal carcinoma typically involves a multimodal approach, which may include:

Our neurosurgeons and ENT (otolaryngology – head & neck) surgeons work closely with radiation oncologists, medical oncologists, and neuropathologists to develop a personalized treatment plan. This includes tumor histological subtyping and genomic sequencing to guide therapy based on the tumor’s unique biology.

Patient Outcomes

With advances in endoscopic skull base surgery, radiation therapy, and chemotherapy, many patients achieve improved survival rates and better quality of life. Early detection and treatment by a multidisciplinary team significantly improve outcomes.

Managing A Sinonasal Carcinoma

Living with sinonasal carcinoma requires comprehensive care, including ongoing monitoring, supportive therapies, and rehabilitation when needed. At PNI, we provide long-term follow-up and support to help patients recover physically and emotionally after treatment.

Meet our Expert Specialists & Surgeons

Abbas A. Anwar, MD

ENT Surgery, Neurorhinology

Garni Barkhoudarian, MD

Neurosurgery

Walavan Sivakumar, MD

Neurosurgery

Chester F. Griffiths, MD

ENT Surgery

Daniel F. Kelly, MD

Neurosurgery

Noa Tal, MD

Endocrinology

Michael Yong, MD, MPH, MBA

ENT Surgery, Neuro-rhinology

Alexander M. Solomon, MD

Neuro-ophthalmology

Howard R. Krauss, MD

Neuro-ophthalmology

Experience Compassionate, Expert Care

At Pacific Neuroscience Institute, we have extensive experience treating complex sinus and skull base tumors. By combining leading-edge endoscopic techniques with advanced imaging and precision therapies, we provide safer, less invasive, and more effective treatments—helping patients achieve the best possible outcomes.

Learn More About a Sinonasal Carcinoma

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