According to current WHO information, nasal tumors are found in one of two hundred cases of neoplasms in otolaryngology. In this case, squamous cell carcinoma of the nasal cavity is the most common ailment - it is diagnosed in eight out of ten patients with suspected benign or malignant neoplasms. All oncological diseases of this organ are divided into internal tumors of the nose and paranasal sinuses, that is, abdominal diseases and those that affect the bone-cartilaginous pyramid and the outer integument.
The main characteristic
Symptoms of oncological diseases of the nasal cavity depend on the type of tumor, its exact location and stage. Malignant tumors of the nose go through four main stages of development:
- latent (latent, asymptomatic);
- period of intranasal localization;
- the stage of tumor exit beyond the borders of the nasal cavity and the germination of cancer in neighboring organs;
- the period of metastasis and damage to nearby lymph nodes.
In some cases, metastases can appear much earlier, starting from the second stage. With the appearance of distant cancer foci, the patient's prognosis is poor, the chances of a five-year survival are minimal. The most dangerous nasal tumors are considered mesenchymal neoplasms (sarcomas), which differ depending on the tissues from which they arise. For example, fibrosarcoma develops from fibrous tissue, and chondrosarcoma affects the nasal cartilage. Both types of cancer are characterized by early metastasis, even at small sizes.
It is extremely rare for patients to be diagnosed with cancer of a mesenchymal nature, which are considered nasal gliosarcomas and dysembryomas that occur at the base of the septum. Mesenchymal tumors are characterized by dense infiltrative growth, the absence of pain and visually noticeable damage to the mucous membrane.
Pyramid of the nose
Cancers of this part of the face can arise from squamous epithelium, which is the outer skin, or from mesenchymal tissues that make up the backbone of the nasal pyramid. A malignant formation can form from bone and connective tissue, including cartilage. Epithelial tumors are diagnosed, as a rule, in adult patients, mesenchymal tumors are found in patients of all age groups.
Epithelial tumors
Depending on the structure of the formation, several types of cancer are distinguished. Cutaneous epitheliomas that arise from the basal layer are collectively called basal cell carcinomas. These are malignant nasal tumors, which most often appear in elderly patients due to malignancy of senile keratosis. Basal cell carcinomas are manifested by various symptoms, reminiscent of a disease such as squamous cell skin cancer. At an early stage, epitheliomas are successfully treated with radiation and chemicals. In appearance, basal cell resemble keratinized spherical formations, which are characterized by rapid growth and the appearance of metastases. In addition, epitheliomas often recur after a course of radiotherapy.
In addition to basal cell carcinoma, there is a cylinder in the classification of epithelial tumors. It arises from the cylindrical epithelium, which is located along the edges of the nostrils. Non-epithelialoma may appear on the nose, a feature of which is the development of a age spots or nevus. The latter species has a separate name - melanoblastoma. So, a neoplasm of the skin of the nose is manifested first by changes in the color of the nevus, its bleeding and ulceration with the slightest damage. Externally, the primary focus of a skin tumor resembles a papilloma or a bleeding ulcer, a pimple.
Neocarcinomas are neuroepithelial in nature and occur in the area of the nose responsible for the function of smell. Symptoms of a tumor in the nose are manifested by irritation of the mucous membrane on the back of the ethmoid bone, but can sometimes occur on the septum.
Sarcomas of the nose pyramid
This type of malignant tumor develops in the nasal cavity and is determined depending on the type of affected tissue. Pathologies of the inside of the nose are divided into fibrosarcomas, chondrosarcomas, and osteosarcomas.
Fibrosarcomas are pathological cancers formed by fibroblasts and huge spindle-shaped cells, which explains the characteristic appearance of such tumors. The second name of the disease is fuscellular sarcoma. It is possible to recognize the disease in time only in isolated cases, the pathology has a progressive malignant nature of the course, rapidly increasing in size and is capable of early metastasis, spreading through the body through the hematogenous route.
Chondrosarcomas are neoplasms of cartilage, which rarely affect the tissues of the nose. Just like the previous type of cancer, this tumor is located inside the nose, it is characterized by a similar malignancy, metastasizes in the early stages.
Osteosarcomas are cancers that develop with high proliferation. Unlike previous types of cancer, osteosarcomas are composed of osteoblasts and mesenchymal cells. The tumor may have a fibrous, cartilage or bone appearance, most often metastases to the lungs and brain. The prognosis of survival for patients with this type of cancer is poor.
Another dangerous type of nasal cancer is lymphosarcoma, which is characterized by proliferation of lymphoid tissue. Lymphorsarcoma is located on the middle nasal concha and septum. Each experienced oncologist is able to recognize any of these types of cancer according to the external signs and characteristics of the clinical course, and the diagnosis is confirmed by histological examination of the removed biopsy.
Nasal cancer
Unlike pyramidal malignancies, tumors of the nose and paranasal sinuses are meant here. Lesions of the internal part of the body - a phenomenon quite rare. According to unofficial data from domestic and foreign oncologists, such diseases make up about 2% of all cancers of the upper respiratory organs. At risk are male.
Epithelium - a generic name for epithelial neoplasms of the nasal cavity. These tumors occur in the sinuses of the nose and on the mucous membrane of the cylindrical ciliary epithelium. One of the varieties of cancer of the internal cavity, as well as the pyramids of the nose, are the cylindromes. Unlike epitheliomas, cylindromes are delimited from neighboring tissues by a kind of capsule. Cavitary epitheliomas are observed mainly in patients older than 50 years, sarcomas can affect even in childhood.
Benign formations
Pathological formations less life-threatening can develop in the nasal cavity. Benign nasal tumors are a group of abdominal atypical structures that originated from different tissues. Non-malignant tumors are characterized by the absence of ulcers, bleeding and metastases.
To differentiate benign pathologies of the nasal cavity from malignant, complex complex diagnostics will be required. Among noncancerous tumors of the nasal cavity, the most common are:
- Papillomas.
- Angiomas
- Polyps (swelling of the sinuses).
- Chondromas.
- Osteomas.
- Fibromas.
- Adenomas.
- Lipomas.
Pathology can be located on any part of the cavity. Symptoms such as:
- nasal congestion;
- difficulty breathing
- violation of smell;
- a feeling of the presence of a foreign body in the nose;
- headache;
- mucous or purulent discharge.
Diagnosis of cancer and non-cancerous tumors
For the diagnosis of benign tumors in the nasal cavity, rhinoscopy is performed and samples of pathological tissues are sent for histological examination. If there is a suspicion of malignant tumors of the sinuses of the nose, the patient is prescribed radiography of the sinuses with a contrast agent, pharyngoscopy, CT of the skull. After confirming the benignness of the tumor, the patient must consult an ophthalmologist.
Non-malignant lesions in the nose are treated by excision using electrocoagulation, laser destruction or sclerotherapy. If cancer metastases are suspected in order to establish their localization, the patient is prescribed an ultrasound scan of the abdominal organs, brain MRI and fluorography of the lungs.
In a predominant number of cases, benign tumors of the nasal cavity are non-invasive, grow slowly, but the need for their treatment cannot be neglected, since under the influence of certain factors they become prone to malignancy. If polyps, adenomas or fibromas are found in the cavity, it is worth starting treatment immediately. In this case, you need to know that some types of pathologies are often complicated by relapses after removal, for example, papillomas and polyps.
The most dangerous of benign tumors are considered to be osteomas and chondromas, which not only destroy surrounding tissues, but also have a risk of degeneration into malignant forms. After removal of such neoplasms, patients often face external defects of the face. In addition, after eliminating the tumor, irreversible respiratory failure and loss of ability to distinguish odors are possible.
Causes of Tumors
Many factors are capable of causing the development of atypical cells in the structure of nasal tissues, which are still not fully understood. By studying the medical history of cancer patients, analyzing their history taking into account the age-related characteristics of health and the conditions of the social sphere, doctors were able to make the most probable assumptions about the nature of the origin of nose cancer.
Harmful working conditions are one of the most common causes of cancer. The constant ingress of toxic and chemical substances into the body through the respiratory system creates favorable conditions for the degeneration of cells and the launch of malignant processes. Most often, a tumor in the nose (photo can be seen in the article) is detected in workers of the woodworking, flour-grinding industry, workers of leather factories, and car repair shops. A strong irritating effect on the nasal mucosa is exerted by pairs of chromium, nickel, and other chemical compounds used in production.
Another cause of cancer is the untreated chronic diseases of the paranasal sinuses (rhinitis, sinusitis). The development of the tumor contributes to a persistent inflammatory process and the activity of pathogenic microflora. Alcohol abuse and smoking can contribute.
According to statistics, the greatest chances of developing a nasal tumor in drug addicts and drug addicts are people who achieve stupefying euphoria by inhaling glue fumes and dry, powdery narcotic substances through the nose. Trauma to the cranial bones can cause cancer. In isolated cases, even a serious nose contusion can provoke the development of a malignant process .
How to quickly cure a tumor and what are the patient's chances of recovery? Definitely no expert can answer this question. The development of cancer, as well as the success of curing it, largely depends on the functioning of the immune system. The weaker the immune system, the less obstacles there are in the development of atypical cells.
Symptoms of a tumor in the nose
The reason for the late diagnosis of cancer is the latency of its symptoms. In the initial stages, the disease is not much different from the course of respiratory and viral infections of the upper respiratory tract. The blurred clinical picture often eases the vigilance of people, as a result of which the opportunity to start fighting the disease at an early stage is missed, and further treatment becomes difficult. Cancer makes itself felt by the appearance of the following symptoms:
- difficulty breathing through the nasal passages for a long time, while vasoconstrictor drugs do not have any therapeutic effect;
- secretion of contents from the nose with an admixture of blood and pus;
- painful ulceration on the nasal mucosa;
- periodic bleeding;
- ear pain due to chronic inflammation of the middle ear;
- headache;
- Hyposmia - deterioration in the sensitivity of olfactory receptors;
- numbness of the face in the nose and paranasal sinuses.
Cancer, unlike benign formations, develops at lightning speed. As the disease progresses and the tumor grows, others gradually join these symptoms:
- severe pains in the nasal cavity appear, which cannot be stopped with the help of conventional painkillers;
- the pain constantly radiates to the upper jaw, it seems as if all the teeth hurt;
- hearing loss, extraneous noise;
- photophobia, increased lacrimation, blepharitis develops;
- the nasal pyramid is deformed, the appearance of the face changes.
When cancer cells begin to germinate in the masticatory muscles, the process of eating will be significantly difficult. It is difficult for patients at the terminal stage to open their mouth normally. If the neoplasm in the sinuses reaches a significant size (more than 2-3 cm), it begins to press in the brain. A tumor of the nose is accompanied by ulcerative lesions of the oral mucosa, tooth loss.
Externally localized cancer is detected much faster than abdominal cancer. But even at an early stage, an experienced otolaryngologist will notice any of the tumors. All formations at first resemble small nodules, cones. It is impossible to independently detect a cancerous tumor in the nasal cavity, therefore, if you suspect a disease, you should immediately consult a doctor.
Common signs of oncology of the nasal cavity
In addition to the specific symptoms of cancer, the characteristic manifestations join the course of the disease:
- fatigue and weakness;
- nausea and dyspeptic disorders;
- weight loss in a short period;
- loss of appetite;
- fetid odor when breathing, which is noticeable even at a distance (may indicate the collapse of the neoplasm).
In adults and in children, nasal tumors affect the lymph nodes, so their enlargement and inflammation can be considered another indirect symptom of cancer.
The main stages of the tumor process
After confirming the diagnosis, the patient is prescribed the appropriate treatment tactics, depending on the stage of the disease. Oncologists distinguish several stages of the malignant process:
- Initially, a cancerous tumor develops in the epithelial layers without affecting the bone structures and lymph nodes.
- In the second stage, the tumor is still within the nose, but its cells can already be found in nearby bones and cartilage.
- For the third stage of a malignant disease, bone destruction and metastatic lesions of neighboring tissues and organs are characteristic.
- The terminal (fourth) stage is accompanied by the penetration of cancer cells into the bones of the lower jaw and cheekbones. At this stage of the disease, the skin of the face is affected, and the lymph nodes located nearby become motionless and fuse with soft tissues, which subsequently leads to the formation of infiltrate and bleeding ulcers.
How to help the patient: treatment methods
Therapy of oncological diseases is selected individually for each patient, taking into account the stage of tumor formation, its exact location, the presence of foci of metastasis and the general condition of the patient. The decision on the surgical treatment of a nasal tumor is made by doctors, as a rule, in the initial stages of cancer and only if the pathology is located in the pyramid of the nose.
But even with indications for surgery, in most cases they resort to a combined approach in the treatment of cancer. First, the patient undergoes a course of radiation and chemotherapy, then the tumor is removed through the nose. Some time after surgery, the patient will have to undergo radio and chemotherapy again.
When treating cancer of any localization, doctors fight for the patient’s life, while issues of aesthetics of appearance appear in the background. Complete removal of the tumor can lead to severe disfigurement of the face. The volume of tissue removed will depend on the degree of involvement of nearby structures in the tumor process. In severe cases, the patient can completely remove the upper jaw and eye sockets. In the presence of metastases in the brain, the possibility of surgical removal of cancer is determined by the neurosurgeon. After successful surgery and recovery, the patient will have to undergo treatment by a plastic surgeon.
In the rehabilitation period, the patient is prescribed a complex of medicines to facilitate well-being and activate tissue regeneration. As a rule, these are antibiotics, hemostatic and vasodilators, hormonal and immunostimulating drugs. After a control diagnosis, which confirms the success of treatment, the patient is put on a dispensary account, which implies the passage of a periodic preventive examination. In case of relapse, treatment is repeated.
An operation to remove a tumor may be ineffective if it is performed at an advanced stage of cancer with complications. In this case, patients are prescribed only palliative therapy to improve the quality of life.
What is the forecast
The chances of a patient recovering are determined by the timeliness of the treatment. If a nasal tumor was detected in the first stages, the probability of positive dynamics is highest. Thus, the use of a combined approach in treatment (radiation therapy, chemotherapy and surgery) allows us to talk about five-year survival of more than 80% of patients. If the pathology was detected at the stage when the cancer has already begun to spread to the lymph nodes, the chances of overcoming the five-year threshold are minimal. Persons who seek help in the fourth stage of nasal sarcoma in most cases die within a year.