Definition

Nasal tumors, or tumors of the nose, are abnormal cell growths in the nasal cavity. They can originate from any nasal structure, including the outer surface layer, blood vessels, nerves, and nasal bone or cartilage. Nasal tumors can be benign (non-cancerous) or malignant (cancerous).

Most nasal tumor cases are benign. Benign tumors usually grow slowly and do not spread to surrounding structures. The difference between malignant and benign tumors is that they can invade nearby tissues and metastasize to other body parts. Nasal tumors are relatively rare, accounting for only 10% of all head and neck tumors, with an estimate of approximately 10 cases per million people annually. They typically occur in individuals over 40 years old and are twice as common in men as in women.

Causes

The exact cause of nasal tumors is poorly understood, but they develop when genes controlling cell growth mutate. Tumors begin with genetic mutations that turn normal, healthy cells into abnormal ones. Unlike normal cells, which grow and die at a controlled rate, abnormal cells proliferate uncontrollably and do not die appropriately. This accumulation of abnormal cells forms a mass known as a tumor. If these cells are malignant, they can invade surrounding tissues and spread to other parts of the body.

Risk factor

The following factors can increase the risk of developing nasal tumors:

• Men are more likely to develop nasal tumors than women.
• Most cases occur in individuals over 40, particularly in their 50s and 60s.
• Both active and passive smoking.
• Breathing air contaminated with pollutants.
• Long-term exposure to chemicals and irritants in the workplace, such as dust, sawdust, glue fumes, alcohol, formaldehyde, flour dust, chromium, and nickel.
• Human Papillomavirus (HPV) infection, a common sexually transmitted infection, can increase the risk.
• Exposure to radioactive substances like radium.

Symptoms

Symptoms of nasal tumors are often subtle, some people can also be asymptomatic, until the cancer grows large enough to affect surrounding structures. Signs and symptoms of nasal tumors may include:

• Difficulty in breathing through the nose
• Nasal blockage, only occur especially on one side
• Loss of sense of smell
• Frequent nosebleeds
• Nasal discharge
• Facial swelling or pain
• Watery eyes
• Sores on the palate
• Vision problems, such as double vision or blurred vision
• Neck lump
• Difficulty in opening the mouth
• Headache

Diagnosis

In diagnosing a suspected nasal tumor, the doctor will ask about the symptoms you experience and potential risk factors of tumors you may have. A thorough physical examination of the eyes, ears, nose, mouth, face, neck, and throat will be performed. The doctor can also recommend other diagnostic tests to help in diagnosing this condition:

• Endoscopy is a thin tube with a light and camera inserted into the nasal cavity to view the structure. The images are sent to a monitor for the doctor to assess the condition of the nasal cavity.
• If abnormalities are found during the endoscopy, a biopsy, a procedure to take or remove a tissue sample from the nose using a special tool, can be performed. This sample is subsequently examined under a microscope to make a final diagnosis and determine the type of tumor.
• Radiological exams such as CT scans and MRI are conducted to provide detailed images of the nasal cavity, determine the tumor's stage, and check for signs of metastasis. CT scans are preferred for examining bone structures and the skull base, while MRI is used for soft tissue details and to assess the spread to the brain.

Management

The management of nasal tumors depends on the location and type of the tumors. Some treatment options include:

Surgery

Most cases of nasal tumors are treated with surgical procedure. Given the proximity of the tumors to vital structures such as the brain, eyes, and nerves that play roles in vision, the surgical approach aims to minimize damage to these areas. The surgical options may include:

• Open surgery. This procedure involves a surgeon making an incision near the nose or in the mouth to access the nasal cavity. The surgeon removes the tumor and any potentially affected areas by the tumors, such as nearby bones.
• Minimally invasive surgery. This procedure utilizes a nasal endoscope and specialized tools inserted through the nose. A small camera on the endoscope allows the surgeon to operate with minimal incisions.

Radiation therapy

Radiation therapy employs high-powered energy, such as X-rays or protons, to kill cancer cells. It can be used alone or combined with surgical procedures to treat nasal tumors.

Chemotherapy

Chemotherapy uses medicines with specific chemicals to kill cancer cells. It may be administered before or after surgery and can also be combined with radiation therapy.

Palliative Care

Palliative care focuses on providing relief from pain and other symptoms of serious condition. A team of doctors, nurses, and other trained professionals work to improve the quality of life for cancer patients and their families. This care can be given alongside other treatments.

Complications

Nasal tumors and their treatments can lead to several complications:

• Scarring from surgical procedures.
• Long-term functional changes in vision, breathing, speech, chewing or swallowing ability due to tumor growth or surgical procedures to remove the tumors.
• Potential damage to nerves affecting facial sensation and movement in the face, shoulders, or arms.
• Radiation therapy side effects, such as pain, nausea, eating difficulty, mouth ulcers, tooth loss, and changes of sense of taste.
• If the tumor is malignant, the tumor cells can spread to other parts of the body.

Prevention

There is no definite way to prevent nasal tumors, but these measures can help you in reducing the risk:

• Quit smoking. Never start smoking. If you currently smoke, talk to your doctor about strategies to quit, such as counseling and medications.
• Workplace safety. Follow safety protocols to protect yourself against harmful fumes and airborne irritants, such as wearing a face mask.

When to see a doctor?

Consult a doctor if you experience symptoms suggestive of a nasal tumor to determine the exact cause and receive appropriate care.

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