Sinonasal neoplasms: Update on classification, imaging features, and management

Vascular sinonasal lesions. How useful is radiology in the diagnosis of rare lesions?

“…Features like bone remodeling and thickening are features of benign lesions, whereas bone destruction, ill-defined margins, and the presence of lymphadenopathy are features of malignancy. 1 However, obtaining tissue for biopsy in vascular lesions, which present with nasal and oral bleeding would further aggravate the condition. Hence, in such situations, the surgeon prefers to reach a provisional diagnosis from the radiological findings to plan for further management.…”

“…However, radiology would be helpful in differentiating between inflammatory, benign and malignant lesion. 1 This is particularly important to decide the further plan of action. But, in certain situations, these diagnostic clues tend to be totally misleading.…”

Imaging Recommendations for Diagnosis, Staging, and Management of Sinonasal Tumors

“…Notable associations are that of the juvenile nasal angiofibroma (JNA) occurring exclusively in males, bimodal distribution of olfactory neuroblastoma with a peak at age 45-55 years and smaller peak at 10 to 25 years, human papillomavirus (HPV) association of inverted papilloma, Epstein-Barr virus association of sinonasal lymphoepithelial carcinoma. 2 Important risk factors for malignant sinonasal tumors are inhaled wood dust (particularly hardwood), leather dust, nickel and chrome pigments. The aforementioned reportedly cause 600-fold increased risk for adenocarcinoma and 20fold increased risk for squamous cell carcinoma (SCC).…”

“…More than 70 histopathological entities of sinonasal neoplasms have been classified by the World Health Organization, based on tissue of origin and differentiation, and grouped under benign and malignant tumours. 2 The American Joint Committee on Cancer-Tumour Node Metastasis (AJCC TNM) staging system for malignancies of the nasal cavity and PNS is referred to for staging of epithelial (non-melanoma) sinonasal tumours. 17 TNM staging of head and neck mucosal melanomas is separately described to stage them.…”

“…Notable associations are that of the juvenile nasal angiofibroma (JNA) occurring exclusively in males, bimodal distribution of olfactory neuroblastoma with a peak at age 45-55 years and smaller peak at 10 to 25 years, human papillomavirus (HPV) association of inverted papilloma, Epstein-Barr virus association of sinonasal lymphoepithelial carcinoma. 2…”