According to current WHO information, nasal tumors occur in one of two hundred cases of neoplasms in otolaryngology. At the same time, the most common disease is squamous cell carcinoma of the nasal cavity - 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 osteochondral pyramid and the outer integument.
Main Feature
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 (hidden, asymptomatic);
- intranasal localization period;
- the stage of tumor exit beyond the boundaries of the nasal cavity and the germination of cancer in neighboring organs;
- period of metastasis and damage to nearby lymph nodes.
In somecases, metastases can appear much earlier, starting from the second stage. With the appearance of distant cancerous foci, the patient's prognosis is unfavorable, the chances of a five-year survival are minimal. The most dangerous tumors of the nose are mesenchymal neoplasms (sarcomas), which differ depending on the tissues from which they arise. So, 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 to be gliosarcomas of the nasal wings and disembryomas that occur at the base of the septum. Mesenchymal tumors are characterized by dense infiltrative growth, absence of pain and visually noticeable mucosal lesions.
Formation of the pyramid of the nose
Cancerous tumors of this part of the face can arise from the squamous epithelium, which is the outer skin, or from the mesenchymal tissues that make up the framework of the nasal pyramid. A malignant formation can form from bone and connective tissue, including cartilage. Epithelial tumors are usually diagnosed in adult patients, mesenchymal tumors occur in patients of all age groups.
Epithelial tumors
Depending on the structure of education, there are several types of cancer. Cutaneous epitheliomas that arise from the basal layer are collectively referred to as basaliomas. These are malignant tumorsnose, which most often appear in elderly patients due to malignancy of senile keratosis. Basaliomas are manifested by various symptoms, resembling such a disease as squamous cell skin cancer. Epitheliomas at an early stage are successfully treated with radiation and chemicals. In appearance, basaliomas 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, cylindroma occurs in the classification of epithelial tumors. It arises from the columnar epithelium, which is located at the edges of the nostrils. A nevoepithelioma may appear on the nose, a feature of which is the development of a pigment spot or nevus. The latter type has a separate name - melanoblastoma. So the neoplasm of the skin of the nose is first manifested by changes in the color of the nevus, its bleeding and ulceration at the slightest damage. Outwardly, 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 nasal pyramid
This type of malignant tumor develops in the nasal cavity and is determined depending on the type of affected tissue. Pathologies of the inner part of the nose are divided into fibrosarcomas,chondrosarcomas and osteosarcomas.
Fibrosarcomas are pathological cancerous formations formed by fibroblasts and huge spindle cells, which explains the characteristic appearance of such tumors. The second name of the disease is fuzcellular sarcoma. It is possible to recognize the disease in time only in isolated cases, the pathology has a progressive malignant course, rapidly increases in size and is capable of early metastasis, spreading throughout the body by the hematogenous route.
Chondrosarcomas are neoplasms of cartilage that rarely affect the tissues of the nose. Just like the previous type of cancer, this tumor is located inside the nose, has a similar malignancy, and metastasizes in the early stages.
Osteosarcomas are cancers that develop with a high proliferative rate. Unlike previous cancers, osteosarcomas are composed of osteoblasts and mesenchymal cells. The tumor may have a fibrous, cartilaginous, or bony appearance, most often metastasizing to the lungs and brain. The survival prognosis for patients with this type of cancer is poor.
Another dangerous type of cancerous tumors of the nose are lymphosarcomas, which are distinguished by the proliferation of lymphoid tissue. Lymphosarcoma is located on the middle nasal concha and septum. Each experienced oncologist is able to recognize any of these types of cancer by external signs and features of the clinical course, and the diagnosis is confirmed usinghistological examination of the removed biopsy.
Nasal Cancer
Unlike pyramidal malignancies, this refers to tumors of the nose and paranasal sinuses. Damage to the internal part of the body is a rather rare phenomenon. According to unofficial data of domestic and foreign oncologists, such diseases account for about 2% of all cancers of the upper respiratory organs. Males are at risk.
Epitheliomas is a generic name for epithelial neoplasms of the nasal cavity. These tumors arise in the sinuses and on the mucous membrane of the cylindrical ciliated epithelium. One of the types of cancer of the internal cavity, as well as the pyramids of the nose, are cylindromas. Unlike epitheliomas, cylindromas are delimited from neighboring tissues by a kind of capsule. Cavity epitheliomas are observed mainly in patients older than 50 years, while sarcomas can affect even children.
Benign growths
Pathological formations that are less dangerous to life can also develop in the nasal cavity. Benign tumors of the nose are a group of cavitary 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 ones, complex complex diagnostics will be required. The most common non-cancerous tumors of the nasal cavity are:
- Papillomas.
- Angiomas.
- Polyps (tumors of the sinuses).
- Chondromes.
- Osteomas.
- Fibroids.
- Adenomas.
- Lipomas.
Pathologies can be located on any part of the cavity. The development of a benign formation is most often indicated by symptoms such as:
- nasal congestion;
- breathing difficulties;
- impaired sense of smell;
- feeling of a foreign body in the nose;
- headaches;
- mucous or purulent discharge.
Diagnosis of cancerous and non-malignant tumors
For the diagnosis of benign formations in the nasal cavity, rhinoscopy is performed and samples of pathological tissues are sent for histological examination. If malignant tumors of the sinuses are suspected, the patient is prescribed x-ray of the sinuses with a contrast agent, pharyngoscopy, CT of the skull. After confirming the good quality of the tumor, the patient must definitely consult an ophthalmologist.
Non-malignant formations in the nose are treated by excision using electrocoagulation, laser destruction or sclerotherapy. If the spread of cancerous metastases is suspected, in order to establish their localization, the patient is prescribed an ultrasound examination of the abdominal organs, an MRI of the brain, and a fluorography of the lungs.
In most cases, benign tumors of the nasal cavity are non-invasive, grow slowly, but neglectthe need for their treatment is impossible, since under the influence of certain factors they become prone to malignancy. If polyps, adenomas or fibromas are found in the cavity, treatment should be started immediately. At the same time, 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 the removal of such neoplasms, patients often have external facial defects. In addition, after the removal of the tumor, an irreversible violation of nasal breathing and loss of the ability to distinguish odors are possible.
Causes of tumors
Many factors that are still not fully understood can cause the development of atypical cells in the structure of nasal tissues. By examining the medical histories of cancer patients, analyzing their anamnesis, taking into account age-related he alth characteristics and social conditions, doctors were able to make the most likely assumptions about the nature of the origin of nasal 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 in the woodworking, flour-grinding industry,workers of leather factories, auto repair shops. Vapors of chromium, nickel, and other chemical compounds used in production have a strong irritating effect on the nasal mucosa.
Another cause of cancer is untreated chronic diseases of the paranasal sinuses (rhinitis, sinusitis). The development of the tumor is promoted by a persistent inflammatory process and the activity of pathogenic microflora. Alcohol abuse and smoking can make a negative contribution.
If you believe the statistics, then the greatest chances of developing a tumor of the nose in drug addicts and drug addicts are people who achieve intoxicating euphoria by inhaling glue vapors, dry powdered drugs through the nose. Trauma to the cranial bones can cause cancer. In isolated cases, even a serious bruise of the nose can provoke the development of a malignant process.
How to quickly cure a tumor and what are the patient's chances of recovery? No one can answer this question with certainty. The development of cancer, as well as the success of its cure, largely depends on the functioning of the immune system. The weaker the immune system, the fewer obstacles encountered in the development of atypical cells.
Symptoms of swelling in the nose
The reason for the late diagnosis of cancer is the concealment 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. A blurred clinical picture often lulls people's vigilance, as a result of which the opportunity to startthe fight against the disease at an early stage is missed, and further treatment becomes difficult. Cancer makes itself felt by the appearance of the following signs:
- difficulty breathing through the nasal passages for a long time, while vasoconstrictor drugs do not have any therapeutic effect;
- discharge from the nose mixed with 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 area of the nose and paranasal sinuses.
Cancer, unlike benign formations, develops at lightning speed. As the disease progresses and the size of the tumor increases, others gradually join the indicated symptoms:
- there is severe pain in the nasal cavity that cannot be stopped with conventional painkillers;
- pain constantly radiates to the upper jaw, it seems as if all the teeth hurt;
- hearing acuity decreases, extraneous noises pursue;
- photophobia develops, increased lacrimation, blepharitis;
- the nasal pyramid is deformed, the appearance of the face changes.
When cancer cells begin to grow into the chewing muscles, the process of eating will be significantly more difficult. It is difficult for patients in the terminal stage to even open their mouths normally. If the neoplasm in the sinuses reaches a significant size(more than 2-3 cm), it begins to press on the brain. A tumor of the nose is accompanied by ulcerative lesions of the oral mucosa, loss of teeth.
Cancer, localized externally, is detected much faster than abdominal cancer. But even at an early stage, an experienced otolaryngologist will notice any of the tumors. All formations initially resemble small nodules, bumps. 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 nasal cancer
In addition to the specific symptoms of cancer, 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 smell when breathing, which is noticeable even at a distance (may indicate the decay of the neoplasm).
In adults and children, tumors of the nose 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 appropriate treatment tactics, depending on the stage of the disease. Oncologists distinguish several stages of the malignant process:
- At first, 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, butits cells can already be found in nearby bones and cartilage.
- The third stage of a malignant disease is characterized by bone destruction and metastatic lesions of neighboring tissues and organs.
- 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 immobile and fuse with soft tissues, which further leads to the formation of infiltration and bleeding ulcers.
How to help the patient: ways of treatment
Therapy of oncological diseases is selected individually for each patient, taking into account the stage of tumor formation, its exact localization, the presence of metastasis foci and the general condition of the patient. The decision to surgically treat a nasal tumor is made by doctors, as a rule, at the initial stages of cancer and only if the pathology is located in the nasal pyramid.
But even with indications for surgery, in most cases, a combined approach in cancer treatment is resorted to. 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 life of the patient, while the issues of aesthetic appearance become secondary. Complete removal of the tumor can lead to severe facial disfigurement. The amount of tissue removed will depend on the degree of involvement in the tumorprocess of nearby structures. In severe cases, the patient can completely remove the upper jaw and eye sockets. In the presence of brain metastases, the possibility of surgical removal of cancer is determined by a neurosurgeon. After a successful operation and recovery, the patient will be treated by a plastic surgeon.
In the rehabilitation period, a complex of medications is prescribed to the patient in order to facilitate well-being and activate tissue regeneration. As a rule, these are antibiotics, hemostatic and vasodilators, hormonal and immunostimulating drugs. After the control diagnostics, which confirms the success of the treatment, the patient is put on a dispensary record, which involves the passage of a periodic preventive examination. If a recurrence is detected, the treatment is repeated.
An operation to remove a tumor may be ineffective if performed at an advanced stage of cancer with complications. In this case, patients are prescribed only palliative care to improve the quality of life.
What is the forecast
The chances of a patient's recovery are determined by the timeliness of the treatment. If the nose tumor was detected in the first stages, the probability of positive dynamics is the highest. Thus, the use of a combined approach in treatment (radiotherapy, chemotherapy and surgery) allows us to talk about a five-year survival rate of more than 80% of patients. If the pathology was detected at the stage when the cancer had already begun to spread tolymph nodes, the chances of overcoming the five-year threshold are minimal. Persons seeking help in the fourth stage of nasal sarcoma, in most cases, die within a year.
