Distant metastasis of the paranasal sinuses – diagnosis, treatment, and life expectancy of a rarity in Oto-rhino-laryngology

Introduction:

Malignancies of the paranasal sinuses are extremely rare. Only 0.3% of all malignant tumors are located in this area. In most cases a primary tumor of the paranasal sinuses is diagnosed, thus metastatic manifestations of other, at the time of diagnosis unknown primary tumors are seen at a fraction.

Due to the rarity diagnosis and therapy have not yet been standardized.

Methods:

A retrospective chart review was performed on patients yielding distant metastasis of the paranasal sinuses treated at our hospital between 2004 and 2015. Five patients were enrolled. Primary tumor site, localization of the metastases, symptoms, and survival were assessed. We present a summary of the relevant literature with special emphasis on epidemiology and clinical characteristics.

Results:

In 60% metastasis was the first symptom and only a hint to a so far unknown primary tumor. Most metastases were located in the spenoid (4/5) with additional findings in the etmoid (2/5) and maxillary sinus (1/5). Primary source of the metastasis was urogenital cancer (3/5), followed by lung cancer (2/5). Time between diagnosis and dead was about 6.2 months with an average age at diagnosis of 69.9 years.

Discussion:

In the literature prostate or renal cancer most frequently account for the primary tumor side. Especially renal cell cancer is known to disseminate to the paranasal cavities. In most cases additional pulmonary or bony metastases can be found. Surgical resection can be reasonable in some cases and should be discussed interdisciplinarily.

Conclusion:

Expansive lesions of the paranasal sinuses are likely a malignant primary tumor.

However, especially in patients with a malignant tumor in their history a metastatic manifestation should be taken into account.

Publication History

Publication Date:
18 April 2018 (online)