Nasal Tumour

Nasopharyngeal and paranasal sinus tumours

SCC is the most common, followed by adenocarcinoma, melanoma, and lymphoma. Rare, but present late.

History: non-specific early symptoms mimicking rhinitis or sinusitis; unilateral nasal obstruction; otitis media (from eustachian tube compression); pain; recurrent haemorrhage. Late symptoms: proptosis, cheek expansion, ill-fitting upper (maxillary) dentures.

Investigations: adults with persistent unilateral nasal symptoms or otitis media should be evaluated with nasendoscopy. A single episode of otitis media may be incidental, but recurrent otitis media in an adult should be investigated.

Management: refer to ENT for diagnosis and management — surgical excision, radiation, and/or chemotherapy depending on staging.

Inverted papillomas

Caused by HPV — benign in themselves, but 10% harbour SCC. Present with unilateral nasal obstruction and sometimes bleeding; seen around the middle meatus, resembling cauliflower-like growths. Treatment is complete excision — refer to ENT.