Types of nasal cavity and paranasal sinus cancer

Several layers of tissue make up each part of the nasal cavity (nose) and paranasal sinuses. Each layer contains many different types of cells. Different cancers can develop from each type of cell. It is important for doctors to recognise these differences, as they help them decide on how best to treat the cancer.

Tumours of the nasal cavity and paranasal sinuses can be

• Non cancerous (benign)
• Cancerous (malignant)

There are several types of non cancerous tumours in these areas. These include

• Polyps (smooth growths of tissue)
• Papillomas
• Growths of small blood vessels, known as angiofibromas and haemangiomas.

Papillomas are wart like growths that are not cancers. But they can cause damage. There is a small risk that they might turn into a squamous cell cancer.

Malignant nasal and paranasal sinus tumours are cancers. In time, they can grow deep into the surrounding tissue and spread to other parts of the body.

Squamous cell carcinoma (SCC) is the most common type of head and neck cancer. More than 6 out of 10 nasal cavity and paranasal sinus cancers (60%) are SCCs. Squamous cells are the flat, skin like cells that cover the lining of the mouth, nose, larynx, thyroid and throat. Carcinoma just means cancer. So squamous cell carcinoma is cancer that starts in these cells.

Squamous cell cancer is by far the commonest, but not the only type of cancer that can develop in the nose and nasal sinuses. Cancers in these places could be

• Adenocarcinomas and adenoid cystic cancer
• Lymphomas
• Plasmacytomas
• Melanomas
• Neuroendocrine carcinomas and olfactory neuroblastomas (previously called ‘esthesioneuroblastomas’)
• Sarcomas

Adenocarcinomas

Adenocarcinomas are the next most common type of cancer in the nose and paranasal sinuses affecting around 10  out of every 100 people (10%) diagnosed with these types of cancers.

The nasal and ethmoid sinuses are the most common site for adenocarcinoma of the head and neck. Adenocarcinoma starts in the gland cells (adenomatous cells) that are scattered around the surface tissues inside the nose. These cells produce mucus (phlegm). The number of adenocarcinomas has increased in the last 20 years, but we don’t know why.

Adenoid cystic cancers

Adenoid cystic cancers are rare cancers of gland tissue. They most often grow in the salivary glands but, much more rarely, can grow in the nose or nasal sinuses.

Lymphomas

Lymphomas are cancers that start in the lymph nodes. There are many lymph nodes in the neck and painless swelling of a lymph node is the most common symptom of lymphoma.

Remember - if you are looking for information on lymphoma, this is not the right section for you. You need to look at the lymphoma section. Your treatment will be very different to the treatment outlined in this section for head and neck cancer.

Plasmacytomas

Plasmacytomas are tumours made up of plasma cells, and are closely related to myeloma. If you are looking for information on plasmacytoma you should go to the myeloma section.

Melanomas

Melanomas develop from the pigment producing cells that give the skin its colour. Melanomas of the head and neck can occur anywhere on the skin or inside the nose or mouth (oral cavity). If you are looking for information about melanoma, you should go to the melanoma section.

Olfactory neuroblastomas

Olfactory neuroblastomas and neuroendocrine carcinomas are very rare tumours found in the nose (nasal cavity). Neuroblastomas develop in the top part of the inside of the nose form cells left behind from a baby's development in the womb. Neuroendocrine tumours develop from specialist cells that respond to signals from other cells by producing hormones. 

Sarcomas

Sarcomas develop from the cells that make up soft tissue. If you are looking for information about sarcoma you should go to the sarcoma section of CancerHelp UK.

Even within a single type, cancers can vary according to what the cells look like under a microscope. Specialists called pathologists examine the cancer cells to see how different they are from normal cells. They classify the cells according to how abnormal they look. Doctors call this differentiation or grade.

Well differentiated cells are 'low grade'. These are most like normal cells. Poorly differentiated cells are 'high grade'. These are most abnormal.

Generally speaking, a low grade cancer with well differentiated cells is likely to grow more slowly and be less likely to spread than a high grade cancer with poorly differentiated cells. But poorly differentiated tumours can vary in how well they respond to treatment, so this is only a rule of thumb.