Info

Sinus

Frequency

Maxillary

33%

Sphenoid

22%

Ethmoid

1 4%

Frontal

9%

Multiple sinuses

22%

*Data based on reference {2085}

swelling, cranial nerve deficits and epistaxis (especially metastatic renal and thyroid carcinomas). In some instances, the metastasis may be the first manifestation of an otherwise clinically occult carcinoma, usually renal cell carcinoma.

Prognosis and predictive factors

Although the eventual outcome is usually poor, prognosis depends, in part, on whether the sinonasal metastasis is isolated or part of widespread disseminated disease. If the metastasis to the nasal cavity and sinuses is localized and treated aggressively, the average survival following discovery of the metastasis may be as long as 20-30 months {1300}.

Fig. 1.99 Metastatic carcinoma. A Renal cell carcinoma metastatic to the maxillary sinus showing clear cells (due to accumulation of glycogen in the cytoplasm) and prominent sinusoidal vascularity. B Secondary prostatic adenocarcinoma. A malignant epithelial proliferation is identified within the large, patulous vessels in the sinonasal tract mucosa. C (Same case as B). The metastatic nature of the tumour (left) was confirmed when the prostate specific antigen (PSA) was strongly and diffusely immunoreactive in the cytoplasm of tumour cells within vascular spaces (right).

Fig. 1.99 Metastatic carcinoma. A Renal cell carcinoma metastatic to the maxillary sinus showing clear cells (due to accumulation of glycogen in the cytoplasm) and prominent sinusoidal vascularity. B Secondary prostatic adenocarcinoma. A malignant epithelial proliferation is identified within the large, patulous vessels in the sinonasal tract mucosa. C (Same case as B). The metastatic nature of the tumour (left) was confirmed when the prostate specific antigen (PSA) was strongly and diffusely immunoreactive in the cytoplasm of tumour cells within vascular spaces (right).

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