Sino-nasal epithelial tumours: a clinicopathological study

ABSTRACT

Epithelial neoplasms are uncommon lesions affecting the sino-nasal tract. To study the incidence, mode of presentation and histological types of sino-nasal epithelial tumours in the surgical pathology material and surgical procedures and outcome. All sino-nasal epithelial tumours, biopsied or surgically excised over a period of six years, were studied. The tumours were classified as benign or malignant. The histology was correlated with the clinical presentation, investigations, surgical procedures and outcome. In six years, there were 139 sino-nasal tumours. One-hundred one epithelial tumors [72.6%] outnumbered the nonepithelial tumours were diagnosed on the basis of histopathology. Forty-five were benign [44.5%] and 56 malignant [55.5%] occurring predominantly in males. Benign lesions included three fungiform papillomas [exophytic] [6.6% of the benign tumors] and 42 inverted papillomas, with recurrence in five inverted papillomas [11.9%]. Malignant changes were detected in two cases of inverted papilmours [4.8%] at initial surgery and in one of five recurrent cases [20%]. Endoscopic and external approaches were of equivalent results. Squamous cell carcinomas were the commonest among malignant tumours with thirty cases [53.2%] and three of these were associated with inverted papillo either synchronously or metachronously. The second most frequent malignant tumour was adenoid cystic carcinoma with twelve cases. Other rare types included the variants of squamous carcinoma, adenocarcinomas, muco-epidermoid carcinoma, and undifferentiated carcinomas. Smoking and environmental pollution were blamed as etiologic factors. Cases mostly presented in late stages. Multimodality treatment including surgery, radiotherapy and chemotherapy was the option to achieve optimal results but still with poor prognosis. Sino-nasal epithelial tumours are rare lesions, with male preponderance. Inverted papillomas and squamous cell carcinomas the most frequent neoplasms