A TERTIARY CARE CENTRE STUDY OF MALIGNANT SINONASAL MASSES

Nidhi Anand*, Nuzhat Husain, Pradyumn Singh, Namrata P.Awasthi, Anurag Gupta, Saumya Shukla, Subrat Chandra, Ashish Singhal and Akash Agrawal

ABSTRACT

Background: The accurate diagnosis of sinonasal tract tumors is challenging as there is considerable overlapping between clinical features, radiology, histologic and immuno-phenotypic findings. Immunohistochemistry (IHC) aids in reaching a diagnosis. The objectives of the current study were to analyse the clinico-pathological, histomorphological and IHC characteristics of malignant sinonasal masses. Materials and Methods: This is a retrospective case series that included 268 cases of nasal mass. The clinico-pathological findings, histomorphology and IHC profile of all the malignant masses (n=25) were analysed. Results: The study included 268 non-neoplastic cases that were sinonasal polyps, fungal and granulomatous masses, angiofibroma, inverted papilloma etc. and 25 cases of malignant sinonasal mass. Based on the comprehensive histomorphological and IHC profile, 68% (17/25) cases were epithelial malignancies, 12 %(3/25) mesenchymal tumours, 16%(4/25) hematolymphoid malignancies and 4%(1/25) case was of malignant melanoma. The M: F ratio was 1.2:1.The maximum no. of cases 24% (6/25) were between the ages of 51-60 years with mean age of 45.84 years. The major complaint of the cases were nasal obstruction, intermittent epistaxis, rhinorrhoea, hyposmia, eye related symptoms, swelling over face and headache. Conclusion: Malignant sinonasal mass comprises histogenetically diverse entities with overlapping morphologic features. To reach the correct diagnosis histology with IHC must be combined with the imaging findings, and clinical findings, as there are significant differences in therapy and overall outcome.

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