Malignant tumors of the nasal cavity often originate secondarily from the maxillary sinus and ethmoid sinus. Pathologically, squamous cell carcinoma is the most common, followed by adenocarcinoma, with rare cases including basal cell carcinoma, lymphoepithelial carcinoma, olfactory neuroepithelial carcinoma, malignant melanoma, and fleshy tumors, all of which have a poor prognosis. Primary tumors are frequently found on the lateral wall of the nasal cavity, the nasal floor, and the nasal septum, whereas those secondary to sinus tumors often make it clinically difficult to identify the primary site. Below is a summary of the common squamous cell carcinoma.

bubble_chart Etiology

In recent years, the incidence of nasal squamous cell carcinoma has shown an increasing trend. The cause of the disease is unclear, with some suggesting it may be related to environmental pollution and long-term exposure to certain chemical products.

bubble_chart Clinical Manifestations

This disease is more common in males than females, with most patients being over 50 years old. It is usually unilateral, but bilateral cases also occur. Approximately 10% of patients have metastases in the parotid gland area and submandibular lymph nodes. In the initial stage, the tumor develops slowly. By the advanced stage, when the tumor extensively involves the eye, maxillary sinus, ethmoid sinus, or anterior cranial base, it can cause symptoms related to cranial nerves II, III, IV, V, VI, and ocular manifestations. Examination reveals a mass in the nasal cavity with an uneven, dark red appearance or polyp-like features, which bleeds easily upon contact. The tumor is brittle during biopsy. If there is proptosis, swelling in the inner canthus, visual impairment, or cervical lymph node metastasis, the tumor is likely in the advanced stage.

Based on the above clinical manifestations and characteristics of the nasal mass, pathological examination should be performed as soon as possible to confirm the diagnosis. Imaging studies such as X-ray and CT can provide information on tumor size and the extent of surrounding tissue involvement, which is significant for selecting surgical approaches and estimating prognosis.

bubble_chart Treatment Measures

For localized tumors, simple radiotherapy can be performed, with a 5-year survival rate exceeding 75%. For tumors with extensive infiltration, a comprehensive approach including radical resection combined with preoperative or postoperative chemotherapy and radiotherapy is recommended, achieving a 5-year survival rate of 40–50%. Prognosis depends on tumor size, pathological type, and the presence of lymph node metastasis.

For surgical approaches to malignant nasal cavity tumors, lateral rhinotomy is generally advocated due to its wide field of view, allowing simultaneous resection of tumors involving the maxillary and ethmoid sinuses. The drawback is facial scarring. In recent years, the midfacial degloving approach has been recommended, offering equivalent efficacy to lateral rhinotomy without facial deformity. For smaller tumors, endoscopic sinus techniques can be employed, enabling complete tumor removal while preserving nasal physiological function.