Nasal Cancer Diagnosis:

Nasal cancer is not only an extremely uncommon disease, but the symptoms are similar to those associated with a sinus infection. This often leads to a delayed nasal cancer diagnosis, which significantly reduces a patient’s chances of survival.

Methods of Nasal Cancer Diagnosis:

There are several steps in establishing a diagnosis of paranasal sinus cancer. The first step is a thorough medical history, followed by a physical examination. The physical examination may reveal a lesion in the nose or a submucosal (below the mucous membrane) mass arising in an adjacent sinus.

After the history and physical examination, a series of tests are performed to determine the precise nature of the suspicious growth and the extent of its spread. These tests may include:

• Biopsy (the removal of a sample of tissue that appears to be suspicious) is performed after a lesion is identified. The tissue is studied under the pathologist's microscope.

• Computed tomography (CT) scan, which is a series of detailed pictures with thin cross-sectional slices taken radiologically through the body and interpreted with a computer.

• Nasoscopy, which utilizes an instrument called the nasoscope for examining the nasal cavity and the paranasal sinuses.


• Magnetic resonance imaging study (MRI), an imaging study that consists of detailed pictures, but instead of using x rays, a powerful magnet is used to polarize electrons inside the body to obtain images, which are then interpreted by a computer.

• Posterior rhinoscopy, in which the nasopharynx and the rear portion of the nose are examined using a light and a special mirror.

Although endoscopic techniques (visualizing the nasal cavity with an endoscope—a tube-like device to which an optical system is attached) have greatly improved the ability to examine the nasal cavities and the paranasal sinuses, radiographic studies are also necessary in completing the evaluation. The most important radiographic studies include CT and MRI scans, usually used in combination. The MRI scan has become the most essential radiographic test for accurate delineation of pretreatment tumor extent, and also for following up patients after treatment.

However, each scanning technique has its own advantages and limitations. The CT scan is preferred in evaluating the bony structures in the paranasal sinus area. The MRI better assesses soft-tissue differences, enabling not only the differentiation of tumor from inflammatory changes in the nose and sinuses, but also the determination of involvement of the soft tissues in, for example, the orbit, the brain, and the optic nerve.

Obtaining a biopsy is crucial to diagnosis. Endoscopic sinus surgery is widely used for obtaining tissue for biopsy. Combining endoscopic surgery with CT imaging, however, allows the surgeon access into small recesses of the nose and sinuses and along the base of the skull, making biopsy not only more accurate but also safer for the patient.