Malignant neoplasm of sphenoidal sinus
Malignant neoplasm of sphenoidal sinus overview:
Malignant neoplasm of sphenoidal sinus is a rare malignant tumor, most occurred in the maxillary sinus, accounting for 86.7%, ethmoid for 43.6% , sphenoid accounted for 2.3%. Sphenoid sinus malignant tumor at the primary and secondary two. Secondary distant organ metastasis in the former cleft adenocarcinoma, myeloma, thyroid cancer, thyroid cancer, lung, liver, breast, kidney and so on. Invasive tumor from adjacent organs, and mainly in the nasal cavity and paranasal sinuses, nasopharynx and sellar tumors.
Primary malignant tumor of the sphenoid sinus squamous cell carcinoma, lymphoepithelial carcinoma, undifferentiated carcinoma, cylindrical cell carcinoma, adenocarcinoma, giant cell tumor, Ameloblastoma, malignant transformation of inverted papilloma and so on. Sphenoid bone as a result of low wall, the tumor susceptible to damage, so the earliest symptoms and signs arising from the sphenoid sinus due to adjacent organ involvement. Metastatic carcinoma than primary carcinoma of the failure process faster.
Malignant neoplasm of sphenoidal sinus Symptoms:
Sphenoid sinus malignant tumor often occur in the adult, no gender differences. in primary sphenoid sinus malignant tumor with nerve expansion, symptoms is headache. Often located in the orbital headache or the ball deep, the lateral or the amount at the top of the depths of the deep, sometimes located in occipital and posterior-proliferation, but also a significant headache for those who do not, then most likely misdiagnosed. Tumor to the lateral wall of the development of the first nerve palsy occurred in outreach, with oblique eyes, diplopia, and after the trochlear nerve palsy have also clinical performance of fixed eye, ptosis, mydriasis. Optic nerve compression may be visually impaired or blind. Unilateral eye symptoms may be the progressive development of bilateral, and there is often accompanied by exophthalmos. Such as violations of sella, pituitary dysfunction may be symptoms. Can also be manifested as diabetes insipidus. Metastatic carcinoma of the sphenoid sinus in addition to the above-mentioned symptoms and signs, the physical examination is often the body can be found in distant primary carcinoma of the symptoms and signs, the clinician of the sphenoid sinus lesions, special attention should be conducted to check the whole body system in order to avoid caused only partial attention to the misdiagnosis.
Malignant neoplasm of sphenoidal sinus Diagnosis:
Malignant tumor of Sphenoid sinus as a result of low incidence, anatomical site of concealment, the early symptoms was not obvious, and easily misdiagnosed. Therefore, to have deep headache, followed by emergence of the first Ⅵ, Ⅳ, Ⅲ, Ⅴ cranial nerve palsy, and should first take into account the sphenoid sinus disease. Such as the rapid progress in the above-mentioned symptoms should be suspected of sphenoid sinus malignant tumor, the patient at this time to conduct a comprehensive inspection, including all body organ, nasal cavity, nasopharynx, ophthalmology, neurology, such as inspection and, more importantly, to be taken is the lateral skull films, skull films, optic film, to be carotid artery angiography, head CT or MRI, to show the tumor size and extension of the scope. Malignant neoplasm of sphenoidal sinus is diagnosed by puncture or open the nasal septum surgery transsphenoidal biopsy taken for histological examination. Sphenoid sinus malignant tumor need to difference with nasopharyngeal carcinoma, mucocele of sphenoid sinus.
Malignant neoplasm of sphenoidal sinus Treatment:
Malignant neoplasm of sphenoidal sinus treatment is using open surgery; tumor resection; microscopic tumor resection at times; radiotherapy.
Sphenoid sinus malignant tumor, in spite of a comprehensive treatment, the prognosis remains poor. Especially secondary to distant organs or neck metastasis. Of the primary tumor, may be opening up and the nasal septum to the sphenoid sinus tumors, but patients must be vigilant against corrosion lateral bone wall of the tumor, the tumor and carotid artery adhesion blindly clamp easily to take the tumor and the occurrence of carotid artery rupture bleeding to death . Method is to avoid at times under the microscope to remove the tumor, such as pulse and found a clear tumor adhesion and should not be forcibly removed, the residual part of the supplementary radiotherapy feasible.