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...
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