Carcinoma of the Nasal Septum

Abstract

\s=b\ Twenty-two patients with nasal septal carcinoma have been treated at the University of Texas Medical Branch, Galveston, during the 18-year period from 1961 to 1979. Squamous cell carcinoma of the nasal septum was found in 18 patients (82%), with single instances of reticulum cell sarcoma, basal cell carcinoma, histiocytic lymphoma, and transitional cell carcinoma. One of the squamous cell carcinoma group had palpable cervical metastasis at diagnosis, with metastatic neck disease developing in eight patients from three to 25 months after treatment. Squamous cell carcinoma of the nasal septum is aggressive and often undertreated. Our experience suggests that patients with septal carcinoma of any size should be treated by wide surgical excision (via lateral rhinotomy) and irradiation to the primary site and neck. Control of the primary tumor was achieved in 17 of 18 patients, with neck control in ten patients. The five-year absolute survival rate for squamous cell carcinoma of the nasal septum was 66%. (Arch Otolaryngol 1984;110:748-751) Nasal septal carcinoma, generally grouped with rare tumors,1·2 has been reported more frequently over the past ten years, with now approxi¬ mately 300 reported cases.39 Most of the patient series are small and have been acquired over many years, -veston, TX 77550 (Dr LeLiever). emphasizing the low incidence.3·6·9·10 The majority of patients with nasal septal carcinoma have squamous cell carcinomas.3·8·9 Other tumor types include malignant melanoma, basal cell carcinoma, transitional cell carci¬ noma, reticulum cell sarcoma, chon¬ drosarcoma, adenocystic carcinoma, adenocarcinoma, small-cell carcino¬ ma, lymphoepithelioma, mucoepider¬ moid carcinoma, and plasmacyto¬ ma. uavi a iog2 Mayo Clinic series, Beatty et al3 added 85 cases of nasal septal carcinoma collected over 61 years, with 58 being squamous cell cancer. They reported the largest series to date. Of patients with squa¬ mous cell carcinoma, they found cervi¬ cal metastasis in 24% and observed an overall five-year survival rate of 67% for all patients with squamous cell carcinoma. They recommended wide surgical excision alone for initial lesions. Young9 reported 43 cases of malig¬ nant septal tumors seen at the Chris¬ tie Hospital and Holt Radium Insti¬ tute, Manchester, England, over a 23-year period. This group included 23 patients with squamous cell carcino¬ ma, one of whom had cervical node disease at the time of initial observa¬ tion. Treatment was predominantly radiotherapy, employing either radi¬ um implant or deep x-ray therapy, with the remaining patients having surgery alone or combined therapy. Overall five-year survival rate for all patients irrespective of treatment was 56%. Schaefer and Hill6 reported 12 cases of squamous cell carcinoma of the nasal vestibule, two patients ini¬ tially seen with lymph nodes. In their series, four patients died of disease. Weimert et al8 reviewed 83 cases of nasal septal carcinoma reported in the literature to 1978 and added a further 14 patients, all with squamous cell c...

Nasal Septal Squamous Cell Carcinoma: A Chart Review and Meta‐analysis

“…In the present study, the 66% overall 5‐year survival rate is consistent with the survival rates in other series with comparable proportions of early‐ and late‐stage lesions 2,7 . However, the small number of patients in each tumor staging and treatment group do not allow for an accurate comparison of survival.…”

“…The known 94% incidence of substantial smoking histories in the present series strengthens the implications of several other studies that tobacco is an etiologic factor in the disease process 2,7 . This relationship is further intensified by the fact that two of the patients had oral second primary tumors, suggesting possible field cancerization as the basis of disease.…”

Clinicopathological and immunohistochemical characteristics of surgically treated primary carcinoma of the nasal vestibule – an evaluation of 30 cases

“…As an explanation to this finding, it is plausible that the majority of our cohort were staged as pT1 and pT2. Neck failure rate of our cohort is lower compared to previous studies that suppose neck failure rate between 20.0% and 54.0% . Langendijk et al .…”

Nasal and paranasal sinus carcinoma: Are we making progress?

“…Several articles on patients who underwent craniofacial resection reported results as good as ours, but the results could not be included in the metaanalysis either because of large numbers of tumors with noncarcinoma histologies or because of a short followup. 8,9,46,[197][198][199] Nevertheless, several reports related outcomes better than ours for patients with squamous cell carcinoma, 48,56,106,100,110,117,132,137,147,160,168,176 for patients with glandular carcinoma, 160,168,184 and for patients with adenocarcinoma. 136,146 The systematic review revealed a steady improvement in treatment results for patients with squamous cell carcinoma and glandular carcinoma (Fig.…”