Carcinoma of sinus

Carcinoma of maxillary sinus, nasopharngeal

carcinomaDr. Asifa Iqbal

BDS MPhil (Oral Pathology & Microbiology)FCPS OMFS(II)

KING EDWARD MEDICAL UNIVERSITY ,LAHORE.

Carcinoma of maxillary sinus Anatomy of sinus Carcinoma Clinical features Leads to tratment planning

Anatomy of maxillary sinus

Pathogenesis Normal Hyperplasia Metaplasia (DNA damage)

Dysplasia (DNA damage) (DNA damage) Anaplasia (DNA

damage) Infiltration (DNA damage) Metastasis…. Progressive DNA Damage – features of neoplasia.

Clinical features Uncommon Dangerous Incidence less than other intra oral sites 642 cases in 10 yr literature survey Age elderly Sex male more Etiology not definite No predisposing factors like ch.sinusitis polyp

Clinical features Presents usually as nasal stuffiness , ulcer , mass nerve involvement tooth ach loosening of denture

With spread Lateral wall ---facial asymmetry Medial wall --- nasal stuffiness Superior ----protrusion of eyeball After lymph node metastasis submandibular or cervical Distant metastasis uncommon

staging 0 inner lining 1 mucous mem 2 bone 3 bone at back of sinus ,underlying tissue

under the skin,eye ball or lymph nodes less than 3 cm

4 A,B,C.

radio graphically

histopathology

Sinonasal undifferentiated tumour Trabaculea and nest of polygonal cells with

minimal cytoplasm pleomorphism hyperchromatism .

Immunhistostaining positive cytokeratin

treatment Surgical Hemimaxilectomy Radiotherpy Prognosis poor 10 -30% 5 yr survival Poor prognostic indicators lymph nodes anatomical difficulty pteygopalatine

fossa

Nasopharyngeal carcinoma Group of malignancies arising from

epith.lining of lymphoid rich nasopharynx Similar tumour found in palatine tonsils and

base of tongue

Clinical features Tumour of Cantonese (south china) Second most frequent tumour in female age Etiology racial EBV Association EBNA-1 Linked with diffrentiation undifferentiated always positive for EB-

viral antigen HLA Typing Contributing factors Salt fish ,nitrosamine

Clinical features

Site of primary lesion Post. or lat.wall.Difficult to assess Enlarged lymph node50-60% presentation Symptoms of primary invasion Epistaxis ,nasal obstruction,partial deafness Cranial nerves palsies. Rapidly fatal laryngeal ,pharyngeal

obstrution.

histopathology SCC keratinizing Diff.non-keratinizing Undiffer.nonkeratinizing Anaplastic lymphowpith. Sinonasal undifferentiated

diagnosis Lateral view CT scan MRI

treatment Surgical difficult Radiotherapy Chemotherapy! Survival rate in US Stage1 100% stage 2 67% stage3 44% stage4 34%