Page 50 - Portuguese Journal - SPORL - Vol 61. Nº2
P. 50
Figure 1 Discussion
Kaplan-Meyer curves for different component There are few published reviews of malignant
of TNM staging for epithelial and mucosal
melanoma tumors. a: five-year overall survival tumors of the nose and paranasal sinuses,
curve for N component (p = 0.025); b: Disease- mainly due to the rarity of these tumors and
free survival course for N component (p = highly histologic diversity . According to
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0.025); c: five-year overall survival curve for T the literature, the peak incidence of these
component (p = 0.092).
tumors occur in the 5 to 7 decades, which
th
th
is according to our results . There is evidence
11
that occupational risk factors contribute to
carcinogenesis of sinonasal malignant tumors.
While adenocarcinomas have been linked
to wood dust, formaldehyde and leather
dust, squamous cell carcinomas have been
associated to arsenic and welding fumes 12, 13 . Our
series showed a slightly male predominance
(57.9%), which is in conformity with literature.
While in other tumors of the head and neck
region, such as laryngeal, oropharyngeal or
hypopharyngeal carcinomas it is reported a
male predominance of over 90%, in malignant
tumors of the nose and paranasal sinuses
the male predominance is lower, probably
because in this latter region, tobacco and
alcohol (classically more associated to males)
do not have a high carcinogenic potential 8, 14 .
The retrospective analysis of 13.295 patients
performed by Dutta et al revealed that the most
common origin of sinonasal malignancies
was the nasal cavity (45.7%) followed by the
maxillary sinus . However, the most common
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location of these malignancies is controversial,
since other studies reported the maxillary sinus
as the most common site 15,16 . These studies
also report the ethmoid sinus as a common
location for this malignancy. Our results
demonstrated a predominance for the nasal
cavity (47.4%), followed by the maxillary sinus
(21.1%). The ethmoid sinus was an uncommon
location (1 patient, 5.3%), probably because
tumors that originate in this region easily gain
access to nasal cavity and subsequently were
classified as overlapping (15.8%).
Most series report nasal obstruction as the
most common presenting symptom 17, 18 . In our
series, both nasal obstruction and epistaxis
were the most common initial symptoms.
Histology of sinonasal malignancies was
classified according to the 4 edition of the
th
192 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery
