Sinonasal Tumors

What Is a Sinonasal Tumor?

A sinonasal tumor is a growth in the nose (nasal cavity), the space behind the nose (nasopharynx), or the sinuses around the nose. These rare tumors can be benign (not cancer) or malignant (cancer).

What Are the Signs & Symptoms of a Sinonasal Tumor?

The most common symptom of a sinonasal tumor is a stuffy nose that stays on the same side and doesn't get better. Other symptoms could include:

• a bloody nose
• coughing up bloody spit or mucus
• drainage in the back of the throat (post-nasal drip)
• headache
• pain above or below the eyes on only one side
• snoring (if the child didn't snore before)
• thick yellowish or greenish white liquid (pus) draining from the nose or throat
• fluid in the ears

Without treatment, a tumor may grow and cause more severe symptoms, such as:

• trouble seeing, which may cause the child to bump into things; not see things to one side; or have double vision, especially when looking to one side
• face numbness
• loss of eye or face movements
• trouble smelling
• loose permanent teeth or tooth loss
• watery eyes
• one or both eyes bulging
• ear pain or pressure
• bumps on the side of the neck (enlarged lymph nodes)
• trouble opening the mouth all the way

What Causes Sinonasal Tumors?

Kids can have different types of sinonasal tumors. In most cases, doctors don't know what causes them. One type of cancerous tumor is related to an unusual virus.

Sinonasal tumor types include:

• Congenital sinonasal tumors: Children who have these tumors are born with them.
• Benign sinonasal tumors: Also called benign neoplasms, these growths are not cancers.
• Malignant sinonasal tumors: These tumors are cancers.
• Inflammatory sinonasal tumors: These are caused by the body's response to an infection or irritation.

A sinonasal tumor may form at any age. Some types are more common in children who have a genetic condition, such as cystic fibrosis, Brooke-Spiegler syndrome, or Cowden syndrome.

How Is a Sinonasal Tumor Diagnosed?

If a doctor is concerned that a child's stuffy nose and any other symptoms aren't from a common cause, such as a cold, they may order tests or refer the child to a pediatric ear, nose, and throat (ENT) specialist.

The ENT doctor may do several kinds of tests to look inside the nasal cavity and sinuses, including:

• passing a small camera into the nose (nasal endoscopy)
• MRI
• CT (CAT) scan

If there is a sinonasal tumor, the doctor may do surgery to get a sample of the tumor tissue (biopsy).

How Are Sinonasal Tumors Treated?

The best treatment for a sinonasal tumor depends on the tumor type, location, and child's age.

A benign (not cancer) sinonasal tumor may:

• respond to medicines
• need to be surgically removed
• shrink on its own, as seen with imaging scans or endoscopy over time

A malignant (cancer) sinonasal tumor may need treatment with:

• medicine (chemotherapy)
• surgery
• radiation therapy

A team of pediatric specialists cares for kids with a sinonasal tumor. These doctors are experts in:

• head and neck surgery (ear, nose, and throat/ENT/otolaryngology)
• blood diseases and cancers (hematology/oncology)
• brain and nerve surgery (neurosurgery)
• radiation oncology
• eye surgery (ophthalmology)
• plastic and reconstructive surgery
• jaw and facial (maxillofacial) surgery
• radiology

How Can Parents Help?

A child with a cancerous sinonasal tumor will need checkups with the care team often. The team will watch carefully for any new tumor growth. Be sure to bring your child to all follow-up care visits.

Having a child being treated for cancer can feel overwhelming for any family. But you're not alone. To find support, talk to anyone on the care team or a hospital social worker. Many resources are available to help you get through this difficult time.