Sinonasal Malignancies and Treatment Outcomes
Summary
Sinonasal malignancies are rare tumours arising in the nasal cavity and paranasal sinuses that account for less than 1% of all neoplasms and present significant diagnostic and therapeutic challenges due to complex anatomy and proximity to the orbit and skull base. The most common histological subtype is squamous cell carcinoma, followed by a diverse spectrum that includes adenocarcinoma, esthesioneuroblastoma, undifferentiated carcinoma and neuroendocrine carcinoma. Symptoms such as nasal obstruction, epistaxis and facial pain are often nonspecific and lead to delayed diagnosis, frequently at advanced stages. Treatment paradigms have traditionally centred on complete surgical resection with clear margins and postoperative radiotherapy, while chemotherapy has been reserved for high-grade or unresectable disease. Advances such as intensity-modulated radiotherapy have improved local control and reduced toxicity. Emerging approaches, including immune checkpoint inhibition and molecularly targeted therapies against drivers such as SMARCA4 mutations, are under investigation. Multimodal treatment tailored to tumour subtype and stage has improved overall survival, but durable control remains elusive for aggressive variants. A multidisciplinary strategy, integrating refined imaging, histopathological classification and modern radiotherapy techniques, is essential to optimise oncological outcomes and preserve function.
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Sinonasal Malignancies and Treatment Outcomes publication trend
The graph below shows the total number of articles in sinonasal malignancies and treatment outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Sinonasal squamous cell carcinoma (SNSCC): A malignant epithelial tumour arising from the mucosal lining of the nasal cavity or paranasal sinuses, characterised by squamous differentiation.
Teratocarcinosarcoma (TCS): A rare and highly heterogeneous sinonasal tumour containing mixed epithelial, mesenchymal, neuroendocrine and germ cell components.
Immune checkpoint inhibitor: A class of drugs that block regulatory pathways in T cells, such as PD-1, to enhance antitumour immune responses.
CDK4/6 inhibitor: A targeted agent that blocks cyclin-dependent kinases 4 and 6, thereby preventing cell cycle progression in tumour cells.
Differentiation grade: A histopathological assessment of how closely tumour cells resemble their normal counterparts, which correlates with aggressiveness and prognosis.
References
- Complete remission in a patient with sinonasal squamous cell carcinoma receiving neoadjuvant tislelizumab plus chemotherapy: a case report. Frontiers in Immunology (2024).
- Characterization of a Preclinical In Vitro Model Derived from a SMARCA4-Mutated Sinonasal Teratocarcinosarcoma. Cells (2023).
- Meta-analysis of 701 published cases of sinonasal neuroendocrine carcinoma: The importance of differentiation grade in determining treatment strategy. Oral Oncology (2016).
- Intensity modulated radiation therapy (IMRT) for sinonasal tumors: a single center long-term clinical analysis. Radiation Oncology (2016).
- Nose and paranasal sinus tumours: United Kingdom National Multidisciplinary Guidelines. The Journal of Laryngology and Otology (2016).
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