Abstract
Imaging evaluation of sinonasal tumors is most often conducted with computed tomography, which excels at identifying the effects of these masses on adjacent osseous structures, and magnetic resonance imaging that is ideal for distinguishing pathologic masses from mucosal thickening and fluid that are common in the sinonasal spaces and depicting extension into the surrounding soft tissues, orbits, and intracranial compartment. Accordingly, the two studies are complementary exams and both are commonly utilized in the assessment of these masses. Less commonly, positron emission tomography can provide additional metabolic evaluation of potential metastatic disease in patients with malignant disease. While these imaging modalities are excellent for the portrayal of an abnormality, there is considerable overlap in the imaging appearance of these tumors and specific imaging manifestations linked to a particular tumor are frequently lacking. Therefore, while the mass may be readily identified, narrowing the differential diagnosis to a single specific entity is rare. Nevertheless, cross-sectional imaging plays an essential role in patient management and valuable guidance for successful biopsy or surgical resection in virtually all cases. This review emphasizes essential imaging manifestations that correlate with sinonasal tumors in general and highlight certain features that may implicate a specific disease process.
Similar content being viewed by others
References
Som PM, Brandwein-Gensler MS, Kassel EE, Genden EM. Tumors and tumor-like conditions of the sinonasal cavities. In: Som PM, Curtin HD, editors. Head and neck imaging. 5th ed. St Louis: Elsevier; 2011. p. 253–410.
Batsakis J. Tumors of the head and neck: clinical and pathological considerations. 2nd ed. Baltimore: Williams and Wilkins; 1979. p. 177–87.
Muir C, Weiland L. Upper aerodigestive tract cancers. Cancer. 1995;75(1 Suppl):147–53.
Nishijima W, Takooda S, Tokita N, Takayama S, Sakura M. Analyses of distant metastases in squamous cell carcinoma of the head and neck and lesions above the clavicle at autopsy. Arch Otolaryngol Head Neck Surg. 1993;119(1):65–8.
Jeans WD, Gilani S, Bullimore J. The effects of CT scanning on staging of tumours of the paranasal sinuses. Clin Radiol. 1982;33(2):173–9.
Som PM, Shapiro MD, Biller HF, Sasaki C, Lawson W. Sinonasal tumors and inflammatory tissues: differentiation with MR imaging. Radiology. 1988;167(3):803–8.
Loevner LA, Sonners AI. Imaging of neoplasms of the paranasal sinuses. Neuroimaging Clin N Am. 2004;14(4):625–46.
Dammann F, Pereira P, Laniado M, Plinkert P, Lowenheim H, Claussen CD. Inverted papilloma of the nasal cavity and the paranasal sinuses: using CT for primary diagnosis and follow-up. AJR Am J Roentgenol. 1999;172(2):543–8.
Ojiri H, Ujita M, Tada S, Fukuda K. Potentially distinctive features of sinonasal inverted papilloma on MR imaging. AJR Am J Roentgenol. 2000;175(2):465–8.
Lund VJ, Lloyd GA. Radiological changes associated with inverted papilloma of the nose and paranasal sinuses. Br J Radiol. 1984;57(678):455–61.
Momose KJ, Weber AL, Goodman M, MacMillan AS Jr, Roberson GH. Radiological aspects of inverted papilloma. Radiology. 1980;134(1):73–9.
Chaudhry AP, Gorlin RJ, Mosser DG. Carcinoma of the antrum: a clinical and histopathologic study. Oral Surg Oral Med Oral Pathol. 1960;13:269–81.
Mafee MF. Imaging of the nasal cavity and paranasal sinuses. In: Mafee MF, Valvassori GE, Becker M, editors. Imaging of the head and neck. 2nd ed. Sttutgart: Thieme; 2005. p. 412–66.
Sigal R, Monnet O, de Baere T, et al. Adenoid cystic carcinoma of the head and neck: evaluation with MR imaging and clinical-pathologic correlation in 27 patients. Radiology. 1992;184(1):95–101.
Regenbogen VS, Zinreich SJ, Kim KS, et al. Hyperostotic esthesioneuroblastoma: CT and MR findings. J Comput Assist Tomogr. 1988;12(1):52–6.
Derdeyn CP, Moran CJ, Wippold FJ 2nd, Chason DP, Koby MB, Rodriguez F. MRI of esthesioneuroblastoma. J Comput Assist Tomogr. 1994;18(1):16–21.
Som PM, Lidov M, Brandwein M, Catalano P, Biller HF. Sinonasal esthesioneuroblastoma with intracranial extension: marginal tumor cysts as a diagnostic MR finding. AJNR Am J Neuroradiol. 1994;15(7):1259–62.
Freedman HM, DeSanto LW, Devine KD, Weiland LH. Malignant melanoma of the nasal cavity and paranasal sinuses. Arch Otolaryngol. 1973;97(4):322–5.
Klein EA, Anzil AP, Mezzacappa P, Borderon M, Ho V. Sinonasal primitive neuroectodermal tumor arising in a long-term survivor of heritable unilateral retinoblastoma. Cancer. 1992;70(2):423–31.
Lane S, Ironside JW. Extra-skeletal Ewing’s sarcoma of the nasal fossa. J Laryngol Otol. 1990;104(7):570–3.
Hillstrom RP, Zarbo RJ, Jacobs JR. Nerve sheath tumors of the paranasal sinuses: electron microscopy and histopathologic diagnosis. Otolaryngol Head Neck Surg. 1990;102(3):257–63.
Miro JL, Videgain G, Petrenas E, et al. Chordoma of the ethmoidal sinus. A case report. Acta Otorrinolaringologica Espanola. 1998;49(1):66–9.
Shugar JM, Som PM, Krespi YP, Arnold LM, Som ML. Primary chordoma of the maxillary sinus. Laryngoscope. 1980;90(11 Pt 1):1825–30.
Ooi GC, Chim CS, Liang R, Tsang KW, Kwong YL. Nasal T-cell/natural killer cell lymphoma: CT and MR imaging features of a new clinicopathologic entity. AJR Am J Roentgenol. 2000;174(4):1141–5.
Cleary KR, Batsakis JG. Sinonasal lymphomas. Ann Otol Rhinol Laryngol. 1994;103(11):911–4.
King AD, Lei KI, Ahuja AT, Lam WW, Metreweli C. MR imaging of nasal T-cell/natural killer cell lymphoma. AJR Am J Roentgenol. 2000;174(1):209–11.
Borges A, Fink J, Villablanca P, Eversole R, Lufkin R. Midline destructive lesions of the sinonasal tract: simplified terminology based on histopathologic criteria. AJNR Am J Neuroradiol. 2000;21(2):331–6.
Gregor RT, Ninnin D. Rosai-Dorfman disease of the paranasal sinuses. J Laryngol Otol. 1994;108(2):152–5.
Ku PK, Tong MC, Leung CY, Pak MW, van Hasselt CA. Nasal manifestation of extranodal Rosai-Dorfman disease–diagnosis and management. J Laryngol Otol. 1999;113(3):275–80.
Wenig BM, Abbondanzo SL, Childers EL, Kapadia SB, Heffner DR. Extranodal sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) of the head and neck. Hum Pathol. 1993;24(5):483–92.
Hussain SS, Simpson RD, McCormick D, Johnstone CI. Langerhan’s cell histiocytosis in the sphenoid sinus: a case of diabetes insipidus. J Laryngol Otol. 1989;103(9):877–9.
Stromberg JS, Wang AM, Huang TE, Vicini FA, Nowak PA. Langerhans cell histiocytosis involving the sphenoid sinus and superior orbital fissure. AJNR Am J Neuroradiol. 1995;16(4 Suppl):964–7.
Som PM, Cohen BA, Sacher M, Choi IS, Bryan NR. The angiomatous polyp and the angiofibroma: two different lesions. Radiology. 1982;144(2):329–34.
Apostol JV, Frazell EL. Juvenile nasopharyngeal angiofibromaA clinical study. Cancer. 1965;18:869–78.
Goff R, Weindling S, Gupta V, Nassar A. Intraosseous hemangioma of the middle turbinate: a case report of a rare entity and literature review. Neuroradiol J. 2015;28:148–51.
Herve S, Abd AI, Beautru R, et al. Management of sinonasal hemangiopericytomas. Rhinology. 1999;37(4):153–8.
Anderson GJ, Tom LW, Womer RB, Handler SD, Wetmore RF, Potsic WP. Rhabdomyosarcoma of the head and neck in children. Arch Otolaryngol Head Neck Surg. 1990;116(4):428–31.
Callender TA, Weber RS, Janjan N, et al. Rhabdomyosarcoma of the nose and paranasal sinuses in adults and children. Otolaryngol Head Neck Surg. 1995;112(2):252–7.
Lee JH, Lee MS, Lee BH, et al. Rhabdomyosarcoma of the head and neck in adults: MR and CT findings. AJNR Am J Neuroradiol. 1996;17(10):1923–8.
Chen CY, Ying SH, Yao MS, Chiu WT, Chan WP. Sphenoid sinus osteoma at the sella turcica associated with empty sella: CT and MR imaging findings. AJNR Am J Neuroradiol. 2008;29(3):550–1.
Wenig BM, Mafee MF, Ghosh L. Fibro-osseous, osseous, and cartilaginous lesions of the orbit and paraorbital region Correlative clinicopathologic and radiographic features, including the diagnostic role of CT and MR imaging. Radiol Clin N Am. 1998;36(6):1241–59.
Osguthorpe JD, Hungerford GD. Benign osteoblastoma of the maxillary sinus. Head Neck Surg. 1983;6(1):605–9.
Han MH, Chang KH, Lee CH, Seo JW, Han MC, Kim CW. Sinonasal psammomatoid ossifying fibromas: CT and MR manifestations. AJNR Am J Neuroradiol. 1991;12(1):25–30.
Engelbrecht V, Preis S, Hassler W, Lenard HG. CT and MRI of congenital sinonasal ossifying fibroma. Neuroradiology. 1999;41(7):526–9.
Wenig BM, Vinh TN, Smirniotopoulos JG, Fowler CB, Houston GD, Heffner DK. Aggressive psammomatoid ossifying fibromas of the sinonasal region: a clinicopathologic study of a distinct group of fibro-osseous lesions. Cancer. 1995;76(7):1155–65.
Som PM, Lidov M. The benign fibroosseous lesion: its association with paranasal sinus mucoceles and its MR appearance. J Comput Assist Tomogr. 1992;16(6):871–6.
Sterling KM, Stollman A, Sacher M, Som PM. Ossifying fibroma of sphenoid bone with coexistent mucocele: CT and MRI. J Comput Assist Tomogr. 1993;17(3):492–4.
Acknowledgments
The author acknowledges contributions of case material to the Armed Forces Institute of Pathology and American Institute for Radiologic Pathology from radiology residents worldwide and from colleagues at the Mayo Clinic.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Koeller, K.K. Radiologic Features of Sinonasal Tumors. Head and Neck Pathol 10, 1–12 (2016). https://doi.org/10.1007/s12105-016-0686-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12105-016-0686-9