Sinus Tumors Invading The Orbit

doi:10.1016/S0161-6420(84)34300-7

Ophthalmology

Volume 91, Issue 3, March 1984, Pages 209-217

https://doi.org/10.1016/S0161-6420(84)34300-7 Get rights and content

Abstract

Forty-seven of 79 patients with sinus and paranasal tumors had clinical, radiographic or operative evidence of orbital involvement. Seventy percent of those patients with orbital extension had clinical or radiographic involvement of the orbit at the time of initial presentation. Common presenting signs and symptoms included proptosis, nasal obstruction or discharge, nasal mass, facial and/or eye pain, visual loss, facial and/or lid edema and diplopia.

The most common tumor seen was squamous cell carcinoma. The maxillary sinus was the most frequent site of origin. Three patients were misdiagnosed as having sinusitis on initial evaluation. A diagnosis of sinusitis is tentative and should be reevaluated early with repeat roentgenographic studies and biopsy, especially in the presence of protracted facial and eye pain. When ordering CT scans, one must specifically request cuts of the base of the sinuses and skull as routine brain CT scans do not evaluate those regions.

Two of four patients with intractable pain unrelieved by narcotics obtained pain relief with cisplatinum.

References (18)

DFN Harrison
The management of malignant tumors of the nasal sinuses
Otolaryngol N Clin Am
(1971)
RH Spiro et al.
Adenoid cystic carcinoma of salivary origin. A clinicopathologic study of 242 cases
Am J Surg
(1974)
DH Abramson et al.
The treatment of orbital rhabdomyosarcoma with irradiation and chemotherapy
Ophthalmology
(1979)
JG Batsakis
J Conley
FA Jakobiec et al.
Secondary and metastatic tumors of the orbit
EL Frazell et al.
Cancer of the nasal cavity and accessory sinuses; a report of the management of 416 patients
Cancer
(1963)
JW Henderson
Orbital Tumors
(1973)
DP Vrabec
The inverted Schneiderian papilloma: a clinical and pathological study
Laryngoscope
(1975)

There are more references available in the full text version of this article.

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Interestingly, these authors found that the expression of HPV types 6/11 and 16/18 was also increased with the degree of dysplastic/malignant change.21 Because of the proximity of the sinonasal passages to the orbit, it is not uncommon for an upper airway tumour, most frequently a squamous cell carcinoma, to invade the orbit.22 Transitional papillomas are capable of invading the orbit and Johnson et al. described four such patients with transitional papillomas of the ethmoid sinus and lateral nasal wall.22
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Approximately, 52% of reported cases of inverted papillomas originated in the nasal cavity, and 32% originate in the ethmoid sinus. Approximately, 79% of the reported cases of squamous cell carcinomas had an epicenter in the maxillary sinus, and from there they extended to the orbit (Table 3; Fig. 3).28,79,81,82,111,143 Approximately, 81% of the reported adenocarcinomas were found with epicenters in the ethmoid sinus, and sinonasal undifferentiated carcinomas had epicenters in the ethmoid sinus, the maxillary sinus, and nasal cavity (Table 3; Fig. 3).2,79,81,97,141,162,172
Tumors that invade the orbit are uncommon. The majority are meningiomas arising from the sphenoid ridge (66%). Others are bone and cartilage tumors arising from the surrounding bones of the orbit, pituitary adenomas, and epithelial tumors arising from the paranasal sinuses and nasal cavity. Meningiomas occur more often in women, whereas epithelial tumors have a predilection for men. Meningiomas and epithelial tumors typically present in the sixth decade of life, whereas bone tumors tend to affect individuals in their third decade of life. Patients often present with a combination of ophthalmological and otorhinolaryngological symptoms, including proptosis, pain, decreased visual acuity, restrictions in motility of the eye, epistaxis, and nasal obstruction. Sarcomas and benign bone and cartilage tumors arise from surrounding structures, whereas carcinomas usually arise from the paranasal sinuses. Surgery is the mainstay of treatment. Depending on the aggressiveness and histology of the tumor, surgery may be combined with radiation and chemotherapy. The prognosis is generally poor, but varies depending on histology and cell origin, size of the tumor, and degree of invasion. Meningiomas and benign bone tumors have the best prognoses. Sinonasal undifferentiated carcinomas, small-cell neuroendocrine carcinomas, osteosarcomas, and rhabdomyosarcomas have poorer prognoses.
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Supported by a Grant from Research to Prevent Blindness, Inc.

Presented at the Eighty-eighth Annual Meeting of the American Academy of Ophthalmology, Chicago, Illinois, October 30–November 3, 1983.

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Sinus Tumors Invading The Orbit

Abstract

Otolaryngol N Clin Am

Am J Surg

Ophthalmology

Secondary and metastatic tumors of the orbit

Cancer of the nasal cavity and accessory sinuses; a report of the management of 416 patients

Cancer

Orbital Tumors

The inverted Schneiderian papilloma: a clinical and pathological study

Laryngoscope