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to environmental carcinogens (see epidemiological aspects Sect. 11.1.1). In Table 2.1 the histological types of malignant sinonasal tumours diagnosed at the Hospital Clinic of the University of Barcelona are presented in decreasing order of frequency. The most frequent histological types are: keratinising squamous cell carcinoma, undifferentiated carcinoma, cylindrical cell carcinoma, malignant lymphoma, malignant melanoma, intestinal-type adenocarcinoma, adenoid cystic carcinoma, low-grade adenocarcinomas and olfactory neuroblastoma.

A practical way to start classifying malignant sinona-sal tumours is to separate them initially into large and small cell categories. Among the large cell malignant tumours the most common types are: squamous cell carcinoma, cylindrical cell carcinoma, malignant melanoma, intestinal-type adenocarcinoma, and low-grade adeno-carcinomas. To the most common small cell tumours belong the sinonasal undifferentiated carcinoma, malignant lymphoma, adenoid cystic carcinoma and olfactory neuroblastoma. Large cell tumours account for approximately 75% of the malignant sinonasal tumours and the small cell tumours for the remaining 25% [41].

For staging of malignant sinonasal tumours the TNM classification of 2002 and the TNM atlas of 2004 are recommended, since nasal cavity tumours are now included [237, 271a].

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