SINONASAL CANCER

Sinonasal Malignancy; Sinonasal Undifferentiated Carcinoma; SNUC; Highly Aggressive Undifferentiated Carcinoma of the Nasal Cavity and Paranasal Sinuses

Sinonasal Cancer is a rare aggressive cancer of the nasal cavity or the paranasal sinuses that mostly occurs in older individuals (over 55 years). This cancer is often confused with other poorly differentiated carcinomas that begin in the sinonasal tract.

Diagnostic testing: The following tests are used to diagnos SNUC:

• •

  Immunohistochemistry of biopsy;

• •

  MRI or CT scans;

• •

  PET scan;

• •

  Electron microscopy; and

• •

  Molecular biologic studies.

Physical findings: Physical findings may include:

• •

  A mass on the nasal cavity;

• •

  Nasal discharge (bloody or runny nose);

• •

  Nasal obstruction;

• •

  Difficulty breathing through the nasal cavity;

• •

  Pressure in the mid-face;

• •

  Double vision (diplopia);

• •

  Proptosis (forward displacement of the eye);

• •

  Chronic infections; and

• •

  Eye papilledema (swelling of the optic disc).

ICD-9: 160.0 – 160.9

People with sinonasal malignancy usually present with advanced stage tumors following a rapid onset of symptoms. The prognosis of SNUC is poor once the cancer invades the skull and brain. Survival after treatment with chemotherapy and radiation is generally less than one year.

By the time this type of cancer is diagnosed, the tumor is usually clinically advanced and surgically unresectable. Treatment for sinonasal cancers involves multimodal therapy including surgical resection, and adjuvant therapy (i.e. chemotherapy, and radiation).

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation:

• •

  Clinical history and examination that describes the diagnostic features of the impairment;

• •

  Pathology report documenting type and stage of tumor;

• •

  Operative reports; and

• •

  MRI or CT scans.

REMARKS

Listing level severity must be documented.