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Carcinoma of maxillary
sinus, nasopharngeal
carcinoma
Dr. Asifa Iqbal
BDS MPhil (Oral Pathology & Microbiology)
FCPS OMFS(II)
KING EDWARD MEDICAL UNIVERSITY ,LAHORE.
Carcinoma of maxillary sinus
 Anatomy of sinus
 Carcinoma
 Clinical features
 Leads to tratment planning
Anatomy of maxillary sinus
Pathogenesis
 Normal  Hyperplasia  Metaplasia (DNA damage) 
Dysplasia  (DNA damage)  (DNA damage) Anaplasia (DNA
damage) Infiltration  (DNA damage)  Metastasis….
 Progressive DNA Damage – features of neoplasia.
Clinical features
 Uncommon
 Dangerous
 Incidence less than other intra oral sites
 642 cases in 10 yr literature survey
 Age elderly
 Sex male more
 Etiology not definite
 No predisposing factors like ch.sinusitis polyp
Clinical features
 Presents usually as
 nasal stuffiness ,
 ulcer ,
 mass
 nerve involvement tooth ach
 loosening of denture
With spread
 Lateral wall ---facial asymmetry
 Medial wall --- nasal stuffiness
 Superior ----protrusion of eyeball
 After lymph node metastasis
 submandibular or cervical
 Distant metastasis uncommon
staging
 0 inner lining
 1 mucous mem
 2 bone
 3 bone at back of sinus ,underlying tissue
under the skin,eye ball or lymph nodes less
than 3 cm
 4 A,B,C.

radio graphically
histopathology
Sinonasal undifferentiated
tumour
 Trabaculea and nest of polygonal cells with
minimal cytoplasm pleomorphism
hyperchromatism .
 Immunhistostaining positive cytokeratin
treatment
 Surgical Hemimaxilectomy
 Radiotherpy
 Prognosis poor 10 -30% 5 yr survival
 Poor prognostic indicators
 lymph nodes
 anatomical difficulty pteygopalatine
fossa
Nasopharyngeal carcinoma
 Group of malignancies arising from
epith.lining of lymphoid rich nasopharynx
 Similar tumour found in palatine tonsils and
base of tongue
Clinical features
 Tumour of Cantonese (south china)
 Second most frequent tumour in female
 age
 Etiology
 racial
 EBV Association EBNA-1
 Linked with diffrentiation
 undifferentiated always positive for EB-
viral antigen
 HLA Typing
 Contributing factors Salt fish ,nitrosamine
Clinical features
Site of primary lesion Post. or lat.wall.
Difficult to assess
Enlarged lymph node50-60% presentation
 Symptoms of primary invasion
 Epistaxis ,nasal obstruction,partial deafness
 Cranial nerves palsies.
 Rapidly fatal laryngeal ,pharyngeal
obstrution.
histopathology
 SCC keratinizing
 Diff.non-keratinizing
 Undiffer.nonkeratinizing
 Anaplastic lymphowpith.
 Sinonasal undifferentiated
diagnosis
 Lateral view
 CT scan
 MRI
treatment
 Surgical difficult
 Radiotherapy
 Chemotherapy!
 Survival rate in US
 Stage1 100%
 stage 2 67%
 stage3 44%
 stage4 34%

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Carcinoma of sinus

  • 1. Carcinoma of maxillary sinus, nasopharngeal carcinoma Dr. Asifa Iqbal BDS MPhil (Oral Pathology & Microbiology) FCPS OMFS(II) KING EDWARD MEDICAL UNIVERSITY ,LAHORE.
  • 2. Carcinoma of maxillary sinus  Anatomy of sinus  Carcinoma  Clinical features  Leads to tratment planning
  • 4.
  • 5. Pathogenesis  Normal  Hyperplasia  Metaplasia (DNA damage)  Dysplasia  (DNA damage)  (DNA damage) Anaplasia (DNA damage) Infiltration  (DNA damage)  Metastasis….  Progressive DNA Damage – features of neoplasia.
  • 6. Clinical features  Uncommon  Dangerous  Incidence less than other intra oral sites  642 cases in 10 yr literature survey  Age elderly  Sex male more  Etiology not definite  No predisposing factors like ch.sinusitis polyp
  • 7. Clinical features  Presents usually as  nasal stuffiness ,  ulcer ,  mass  nerve involvement tooth ach  loosening of denture
  • 8. With spread  Lateral wall ---facial asymmetry  Medial wall --- nasal stuffiness  Superior ----protrusion of eyeball  After lymph node metastasis  submandibular or cervical  Distant metastasis uncommon
  • 9.
  • 10. staging  0 inner lining  1 mucous mem  2 bone  3 bone at back of sinus ,underlying tissue under the skin,eye ball or lymph nodes less than 3 cm  4 A,B,C. 
  • 13. Sinonasal undifferentiated tumour  Trabaculea and nest of polygonal cells with minimal cytoplasm pleomorphism hyperchromatism .  Immunhistostaining positive cytokeratin
  • 14. treatment  Surgical Hemimaxilectomy  Radiotherpy  Prognosis poor 10 -30% 5 yr survival  Poor prognostic indicators  lymph nodes  anatomical difficulty pteygopalatine fossa
  • 15. Nasopharyngeal carcinoma  Group of malignancies arising from epith.lining of lymphoid rich nasopharynx  Similar tumour found in palatine tonsils and base of tongue
  • 16.
  • 17.
  • 18. Clinical features  Tumour of Cantonese (south china)  Second most frequent tumour in female  age  Etiology  racial  EBV Association EBNA-1  Linked with diffrentiation  undifferentiated always positive for EB- viral antigen  HLA Typing  Contributing factors Salt fish ,nitrosamine
  • 19. Clinical features Site of primary lesion Post. or lat.wall. Difficult to assess Enlarged lymph node50-60% presentation  Symptoms of primary invasion  Epistaxis ,nasal obstruction,partial deafness  Cranial nerves palsies.  Rapidly fatal laryngeal ,pharyngeal obstrution.
  • 20. histopathology  SCC keratinizing  Diff.non-keratinizing  Undiffer.nonkeratinizing  Anaplastic lymphowpith.  Sinonasal undifferentiated
  • 21.
  • 23. treatment  Surgical difficult  Radiotherapy  Chemotherapy!  Survival rate in US  Stage1 100%  stage 2 67%  stage3 44%  stage4 34%