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Squamous Carcinoma of Paranasal Sinus

Etiology: • Associated with cigarette smoking most strongly • Human papillomavirus genome has been detected • Nickle ore exposure

Pathogenesis: • ? whether same mechanism of BPDE (catabolite of benzo[a]pyrene in cigarette smoke) binds p53 mutational hot spots as in lung carcinoma • p53 mutation affects cell replication and centromere replication

Epidemiology: • Usually men with long cigarette smoking history • Age generally >50 years

General Gross Description: • Granular, gray white, exophytic or ulcerated neoplasms • May erode bone or occasionally infiltrate it and result in pathologic fracture

General Microscopic Description: • Hyperchromatic nuclei with irregular outlines • Prominent nucleoli • Can range from well to poorly differentiated • May be keratinizing with pearl formation

Clinical Correlations: • Present with pain in sinus • All neoplasms spread to the regional lymph nodes • Eventually spread to lungs and other distant sites • Extensive morbidity and mortality due to local disease with airway obstruction, hemorrhage, infection • Treatment modalities include surgery and radiation • Death usually due to local spread

References: • Sternberg SS. Diagnostic Surgical Pathology. 2nd edition. Raven Press. New York. 1994, pp. 861-2.