耳鼻喉科Otolayngology topic two: paranasal sinuses and non-epithelial tumors

Paranasal sinuses and non-epithelial tumors

1. Benign non-epithelial tumors

-- Fibroosseous lesion: osteoma, fibroma, chordoma...slow in growth

 Osteoma

                              <epi.>       associated: Gardner’s syndrome

                              <location> Frontal sinus

                             <prog.>      5 year survival 74~100%

                             <DDx>        fibrous dysplasia (GGO on CT, do not suggest surgery)

 Peripheral nerve sheath tumor (mostly benign)

                              <location> CN2, 

                              <micro>    2/3 schwannomas, 1/3 neurofibromas

                             <treat>      surgery if symptoms(+)

2. Malig. non-epithelial tumors (more common than benign non-epi.)

Three large groups

-- non-epithelial 

-- lymphoreticular

-- metastatic

3. Group one: non-epithelial 

-- Neurogenic sarcoma associated with neurofibromatosis 

-- Rhabdomyosarcoma with bimodal occurrence/worse outcome in adults

-- Fibrosarcoma associated with trauma and radiation 

-- Chondrosarcoma at jaw

-- Hemangiopericytoma from pericytes

-- Lymphoma : NK/T  cell in Asians, B cell in Westerners; recur @ abd., need CHEMO

4. Group three: metastatic

-- usually from kidney, breast, lung

5. Radiation therapy

-- Adenoid cystic carcinomas

-- Melanoma

6. Surgeries: Weber Ferguson, Maxillectomy, Mid-facial Degloving, Skull base surgery, Craniofacial resection, Orbit exenteration...