Nasal tumors can occur in the nostrils, the interior nasal cavity, or the paranasal sinuses. Malignant, or cancerous tumors, are rare. In fact, less than 50 cases are diagnosed in the US each year. An average of 500 cases are diagnosed in the UK each year, however, and South Africa and Japan appear to experience nasal cancer even more frequently. While nasal cancer is treatable with a favorable outlook in most cases, the specific course of treatment and prognosis depends on the type of tumors present, the type of cells in which they develop, and how far the cancer has spread.
It should also be noted that many types of nasal tumors are malignant, or non-cancerous. For example, overgrowths of tissue in the nostrils are known as polyps, while overgrowth in tiny blood vessels produce what’s known as angiofibromas and haemangiomas. A nasal papilloma, on the other hand, is more like a wart. While these types of tumors are not cancerous, they can progress to squamous cell cancer over time. In addition, polyps and inverted papillomas are associated with the human papilloma virus.
The most common form of cancerous nasal tumors are squamous cell carcinomas, which initiate in the flat, fish scale-like cells found in the lining of mucous membranes. The next most common type are adenocarcinomas, which begin in glandular cells. Like papillomas, adenocarcinomas are also associated with a virus, in this case Epstein-Barr. Other types of nasal tumors that indicate the presence of cancer include sarcomas, melanomas, lymphomas, plasmacytomas, and very rarely neuroendocrine carcinomas. These types of cancerous nasal tumors develop in soft tissue cells, skin pigment cells, lymph nodes, plasma cells, and neuroendocrine cells, respectively.
Possible risk factors that may lead to the development of nasal cancer include smoking, a history of hereditary retinoblastoma, infection with certain viruses, multiple nasal polyps, and chronic exposure to certain chemicals and textile dust. In fact, nasal cancer has been linked to environmental and occupational toxins, such as formaldehyde, nickel, chromium, and dust generated from working with wood, leather, and asbestos. In addition, nasal cancer tends to occur more frequently in women than men.
If nasal cancer is suspected, diagnostic testing typically begins with an examination of the nasal cavity and sinus cavities via nasoendoscope and panendoscopy. Ultrasound imaging may also be used. Suspicious sites may be aspirated by needle or biopsied for further laboratory analysis.
Treatment options vary according to the grade and stage of the cancer, as well as taking the patient’s age and pre-existing medical conditions into account. Generally, most nasal cancers are addressed surgically, with the highest rate of success applying to early stage cancers. Some types of cancers, however, require more aggressive treatment, such as chemotherapy and radiotherapy.