Nasal Tumors

Overview

Nasal tumors are abnormal growths that develop inside the nasal cavity or in the paranasal sinuses, the air-filled spaces in the bones around the nose. They range from harmless to serious. Many growths in this area are benign, meaning they do not spread, such as nasal polyps and certain papillomas. Others are malignant (cancerous) and can invade nearby tissue.

Because the nose and sinuses sit close to the eyes, brain, and major nerves, tumors here can cause a wide range of symptoms as they grow. Early signs are easy to mistake for a lingering cold or sinus infection, which is one reason these tumors are sometimes found late. Persistent, one-sided symptoms are an important clue that warrants evaluation.

Symptoms

Symptoms often affect one side of the nose and do not clear up the way an ordinary infection would. They may include:

• Persistent nasal blockage or stuffiness, often on one side.
• Recurrent nosebleeds or blood-tinged nasal discharge.
• A reduced or lost sense of smell.
• Ongoing facial pain, pressure, or numbness.
• Swelling or a lump on the face, around the eye, or on the roof of the mouth.
• Watery eyes, bulging of the eye, double vision, or vision changes if a tumor presses on the eye socket.
• Loose teeth or a sore on the palate that does not heal.

Symptoms that persist for weeks, occur on one side only, or include unexplained bleeding should be checked by a doctor.

Causes

Nasal tumors form when cells in the lining or supporting tissues of the nose and sinuses grow abnormally. The exact trigger is often unknown, but several factors are linked to cancerous sinonasal tumors:

• Long-term exposure to certain dusts and fumes, including wood dust, leather dust, and some industrial chemicals such as nickel and chromium compounds.
• Tobacco smoke.
• Certain viral infections, including some types of human papillomavirus (HPV).
• Chronic inflammation of the nose and sinuses in some cases.

Benign growths such as polyps are commonly related to long-standing inflammation, allergies, or asthma rather than these occupational exposures.

Risk Factors

Factors that may increase the risk of a sinonasal tumor include:

• Occupational exposure to wood, leather, or textile dust, or to nickel and similar metals.
• Smoking and other tobacco use.
• Older age, as many sinonasal cancers occur later in life.
• Being male, who are affected somewhat more often in some tumor types.
• A history of HPV infection in the upper airway.

Having a risk factor does not mean a tumor will develop, and many people with nasal tumors have no clear risk factor.

Diagnosis

Because early symptoms mimic common nasal problems, diagnosis often begins when symptoms persist or appear on only one side. Evaluation may include:

• Nasal endoscopy, in which a thin, lighted scope is passed into the nose to view the cavity and sinuses directly.
• Imaging such as CT scans to show bone detail and MRI to show soft tissue and the tumor's extent.
• Biopsy, the removal of a small tissue sample for examination under a microscope, which is the only way to confirm whether a growth is benign or cancerous and what type it is.
• Additional scans to check whether a cancer has spread, if needed.

Treatment

Treatment depends on whether the tumor is benign or cancerous, its type, size, and location, and the person's overall health.

• Surgery is the main treatment for most nasal tumors. Many can be removed through the nostrils using endoscopic techniques; larger or more invasive tumors may need open surgery.
• Radiation therapy may be used after surgery for cancer, or as a primary treatment when surgery is not possible.
• Chemotherapy may be added for certain cancers, sometimes alongside radiation.
• Watchful monitoring may be appropriate for some small, benign growths.

Care is often coordinated by a team that can include an ear, nose, and throat surgeon, a cancer specialist, and a radiation oncologist. For benign polyps, medications and treating the underlying inflammation are often part of management.

Prevention

Not all nasal tumors can be prevented, but some steps lower the risk of sinonasal cancer:

• Avoid tobacco and secondhand smoke.
• Use proper protective equipment, such as dust masks and ventilation, when working around wood, leather, metal, or chemical dust.
• Follow workplace safety guidelines for handling known hazardous materials.

Promptly evaluating persistent, one-sided nasal symptoms does not prevent a tumor but can help find one earlier, when treatment is often more effective.

When to See a Doctor

See a doctor if you have nasal blockage, discharge, or pain on one side that lasts more than a couple of weeks, or repeated nosebleeds without a clear cause. Also seek evaluation for a new lump on the face or palate, a non-healing sore, or loosening teeth.

Get prompt medical attention for vision changes, bulging of an eye, double vision, facial numbness, or severe or repeated bleeding, as these may mean a tumor is affecting nearby structures. Early assessment improves the chance of a good outcome.

Related Topics

Frequently Asked Questions

References

1. American Cancer Society. Nasal cavity and paranasal sinus cancer.
2. National Cancer Institute (NCI).
3. Mayo Clinic.
4. MedlinePlus, U.S. National Library of Medicine.