Neoplasms of nasal cavity
Neoplasms of nasal cavity • Both benign and malignant tumours of the nasal cavity are uncommon. Very often their separation from tumours of paranasal sinuses is difficult except in early stages. In addition to primary tumours, nasal cavity can be invaded by growths from paranasal sinuses, neopharynx, cranial or buccal cavity
Neoplasms of nasal cavity • Benign lesions are usually smooth, localised and covered with mucous membrane. Malignant ones are usually fiable, have a granular surface and tend to bleed easily
Benign neoplasms • 1. Squamous papilloma. Verrucous lesions similar to skin warts can arise from the nasal vestibule or lower part of nasal septum. They may be single or multiple, pedunculated or sessile. Treatment is local excision with cauterisation of the base to prevent recurrence. They can also be treated by cryosurgery or laser
Benign neoplasms • 2. Inverted papilloma (Transition cell papilloma or Ringertz tumour). It is so –named because microscopically neoplastic epithelium is seem to grow towards underlying stroma rather than on the surface. Mostly seen between 40-70 years with male preponderance (5:1). It arises from the lateral wall of nose and is always unilateral. It presents as red or grey masses which may be translucent and oedematus, simulating simple nasal polypi
Benign neoplasms • inverted papilloma (Transition cell papilloma or Ringertz tumour). Inverted papilloma has a marked tendency to recur after surgical removal and might be associated with squamous cell carcinoma in 10-15% of patients. Treatment is wide surgical excision by lateral rhinotomy or medial maxillectomy and en bloc ethmiodiectomy
Benign neoplasms • 3. Plemorphic adenoma. Rare tumour, usually arises from the nasal septum. Treatment is wide surgical excision
Benign neoplasms • 4.Schwannoma and meningioma. They are uncommon tumours which are found intranasally. Treatment is surgical excision by lateral rhinotomy
Benign neoplasms • 5. Haemangioma. It may be: (a). Capillary haemangioma. It is soft ,dark red, pedunculated or sessible tumours arising from anterior part of nasal septum. Usually it is smooth but may become ulcerated and present with recurrence epistaxis and nasal obstruction. Treatment is local excision with a cuff of surrounds mucpoerichondrium
Benign neoplasms • 5. Haemangioma. (b). Cavernous haemangioma. It arises from the turbinates on the lateral wall of nose. It is treated by surgical excision with prelimiary cryotherapy. Extensive lesions may require radiotherapy and surgical excision