Secondary tumours

Definition

Tumours that involve the nasal cavity and paranasal sinuses that originate from, but are not in continuity with, primary malignant neoplasms of other sites. Leukaemias and lymphomas are excluded.

Epidemiology

Metastases to the nasal cavity and paranasal sinuses are rare {1300,2085} and may occur in any age group. In a review of 82 cases, the median age of patients with metastatic tumours at diagnosis was 57 years (range 3 months to 76 years), and about 60% were males {202}.

Localization

The distribution of tumour among the paranasal sinuses and the most frequent tumour types to metastasize to these sites are shown in the Table 1.8 and 1.9. In 10-15% of cases, the metastases are limited to the nasal cavity.

Clinical features

Metastases to the sinonasal tract are haematogenous. They may be solitary or multifocal and ordinarily produce symptoms indistinguishable from those of a primary tumour. These include nasal obstruction, headache, facial pain, visual disturbances, exophthalmos, facial

Table 1.8 Most frequent sites of primary tumours that metastasize to the paranasal sinuses*

Primary Tumour

Frequency

Kidney

40%

Lung

9%

Breast

S%

Thyroid

S%

Prostate

7%

Miscellaneous

2S%

*Data derived from reference {2085}

Table 1.9 Distribution of 168 tumours metastatic to

paranasal sinuses*

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