Pattern of sinonasal tumours presented in Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh

Abstract

Introduction: Sinonasal tumors most commonly arise from the nasal cavity, followed by the maxillary and ethmoid sinus; sphenoid and frontal sinus tumors are both extremely rare entities. In the sinonasal complex, squamous cell carcinoma (SCC) is the most common histology, constituting 40 to 50% of all sinonasal malignancies.  Objective: To assess the pattern of sinonasal tumors presented in Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh. Methods: This is a retrospective study carried out in the Department of ENT & Head-Neck Surgery, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from January to June 2022. It includes 52 cases of neoplastic sinonasal growths. All cases were thoroughly evaluated including history, head and neck examination including endoscopy, imaging and histopathological examinations. All the non-neoplastic cases were excluded from the study. Details of clinical presentation, examination, radiological and histopathological findings were recorded.  Results: A total of 52 sinonasal tumors presented during the period. Out of which, 41 were benign and 12 were malignant tumors. Out of 41 benign tumors, inverted papilloma was the most common comprising   12 cases (22.6%) followed by squamous (epithelial) papilloma 11 cases (20.8%), hemangioma 10 cases (18.9%), osteoma and fibrous dysplasia each 2 cases (3.8%) and ossifying fibroma, pleomorphic adenoma and angiomyoma one case each (2%). Out of 12 malignant tumors, squamous cell carcinoma was the commonest malignancy observed in the study. They were four in number (7.5%), followed by basal cell carcinoma in three cases (5.7%) and malignant melanoma in two (3.8%). Adenocarcinoma, osteosarcoma and Rhabdomyosarcoma were each one in number (5.37%) (Table-1). Nasal blockage (94.3%), nasal discharge (66.04%), epistaxis (39.6%), hemifacial pain/pressure (34%) and facial fullness/external deformities, each (18.9%) were among the commonest presentation. Conclusion: The similarities of benign and malignant disorders at initial presentation may lead to a significant delay in the diagnosis of malignancy. Key indicators of malignancy such as cranial neuropathies and proptosis are uncommon at initial presentation and signify advanced disease. Neoplasms of the nasal cavity and paranasal sinuses are rare but require a high index of suspicion for diagnosis due to the overlapping presentation between benign and malignant ones.