Tumours of the nose and sinuses range from common benign growths to rare cancers. Nasal polyps are not tumours, but they can look similar. Benign tumours include inverted papilloma, osteoma and, in teenage boys, juvenile angiofibroma. Cancers include squamous cell carcinoma, adenocarcinoma, olfactory neuroblastoma, melanoma of the lining and lymphoma. Skin cancer on the outside of the nose is a separate and much more common problem.
The early symptoms mimic sinusitis, so diagnosis is often delayed. The key warning feature is that symptoms affect one side only. Treatment is mainly surgical, increasingly through the nostrils with endoscopes, with radiotherapy added for cancers.
Symptoms
- Blockage of one nostril that does not clear
- Repeated nosebleeds or bloodstained discharge from one side
- Reduced sense of smell
- Pain, pressure or numbness in the cheek, upper teeth or around the eye
- Double vision, a watery or bulging eye
- Loose upper teeth or a swelling in the palate or face
- A lump in the neck
Causes and risk factors
Occupational exposure is a well-established cause of sinonasal cancer: hardwood dust in furniture making is linked to adenocarcinoma, and leather dust, nickel, chromium and formaldehyde also raise risk, typically after decades. Smoking increases the risk of squamous cell carcinoma. HPV is found in a proportion of inverted papillomas and cancers. Inverted papilloma is benign but recurs if incompletely removed and turns malignant in roughly one in ten cases. Juvenile angiofibroma is a highly vascular benign tumour affecting adolescent males, thought to be hormone-related.
How it is diagnosed
- Nasal endoscopy: A thin camera examines the nasal cavity in the clinic under local anaesthetic spray. It is the first step for any one-sided symptom.
- CT of the sinuses: Shows bone erosion and the anatomy needed for surgery.
- MRI with contrast: Separates tumour from trapped mucus and shows spread towards the eye socket, brain lining and nerves.
- Biopsy: Taken through the nose once imaging is done. Suspected angiofibroma is not biopsied in clinic because it can bleed heavily.
- Neck imaging and PET-CT: Used to stage confirmed cancers.
Treatment options
- Endoscopic removal: The standard approach for inverted papilloma and many other tumours, with the attachment site drilled to lower recurrence, and no facial incisions.
- Embolisation followed by surgery: For juvenile angiofibroma, the blood supply is blocked 1 to 2 days before removal to reduce bleeding.
- Open or combined skull base surgery: For extensive cancers involving the face, eye socket or skull base, carried out jointly by ENT surgeons and neurosurgeons, with reconstruction.
- Radiotherapy: Given after surgery for most cancers, daily for about 6 weeks, or as main treatment with chemotherapy when surgery is not feasible. Proton therapy may be considered near the eyes and brain.
- Chemotherapy and other systemic treatment: For certain tumour types and advanced disease, and standard for lymphoma.
- Endoscopic surveillance: Regular clinic endoscopy and scans for years, since recurrences can be treated if found early.
When it is urgent
Seek emergency care nearby for a nosebleed that does not stop after 20 minutes of firm pressure or that is very heavy, for sudden loss or doubling of vision, for a swollen, painful eye with fever, or for severe headache with neck stiffness or clear watery fluid dripping from the nose after surgery.
Travelling to Türkiye for treatment
One-sided nasal symptoms lasting more than 3 to 4 weeks should be examined by a local ENT specialist first. A visit can suit endoscopy with imaging and biopsy, a second opinion on pathology, or planned endoscopic or skull base surgery, which typically needs 10 to 14 days and clearance before flying. Six weeks of radiotherapy is only practical abroad if you can remain for the whole course. Long-term endoscopic follow-up should be arranged with an ENT specialist at home.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
الأسئلة المتكررة
Are nasal polyps a kind of tumour?
No. Polyps are swellings of inflamed lining, usually on both sides. A polyp on one side only should be biopsied to make sure it is not something else.
Can inverted papilloma become cancer?
In about 5 to 15 percent of cases it contains or later develops cancer, and it tends to recur if any is left behind. Complete removal and follow-up are therefore advised.
Will surgery leave a scar on my face?
Most benign tumours and many cancers are now removed entirely through the nostrils. Larger cancers may need external incisions.
I worked with wood for years. Should I be checked?
There is no formal screening programme, but tell your doctor about the exposure and have any one-sided blockage or bleeding examined promptly.