A young woman wanted a nose job. During the initial examination of her nose, the plastic surgeon discovered cancer in her sinus cavity.
Cancer of the sinus cavity is known as paranasal cancer. It has a poor prognosis but is also very rare.
A nose job is also called a rhinoplasty. The patient wanted this procedure for cosmetic purposes.
It is by sheer chance and extreme luck that the malignant tumor was found under these circumstances.
After all, by the time that many of these masses are discovered, they have grown beyond the early stage at which they are more curable.
Cancer Inside the Nose Found During Routine Inspection for a Rhinoplasty
Paranasal tumors (about half are malignant) may or may not present with a visible or palpable lump on or near the nose by the time other symptoms begin setting in.
Was there a visible lump preop?
“It was a sinonasal cancer deeper inside the nose, so there wasn’t any external signs,” says the woman’s surgeon, Houtan Chaboki, MD, Owner/President of Potomac Plastic Surgery in Washington, DC.
Why did the patient want the nose job?
“The patient was a young woman in her 20’s who wanted to improve the profile, similar to a majority of rhinoplasty patients,” says Dr. Chaboki.
“There wasn’t a physical change to the external nose from the cancer. The tumor was found during office examination by me in the rhinoplasty evaluation.”
This is frightening information because, all along, this often lethal cancer was growing inside her nose without her having any idea of its existence.
Had the patient never wanted this cosmetic nose job, the tumor would have had a chance to grow big enough to eventually cause symptoms.
Symptoms of Sinus Cancer
• Visible or palpable lump or bump on or near the nose
• Blood or mucus discharge from the nose
• Reduced sense of smell
• Feeling of nasal congestion
• Tearing or excessive watering of one eye
• Voice changes
• Bulging of an eye
• Facial numbness
• Loose teeth
• Trouble opening the mouth
These symptoms have many benign causes as well such as TMJ disorder, allergies and chronic sinus infection.
Dr. Chaboki explains that the young woman, “as with many rhinoplasty patients, have chronic nasal congestion and allergy symptoms. I don’t recall her having other symptoms, such as bleeding, headaches or visual problems.”
At what point did you suspect/find the tumor?
“I found a mass inside her nose on the initial office examination, then obtained a CT sinus, and finally an office biopsy confirmed the pathology.”
What stage was it?
“Fortunately, it was early stage and treated with surgery.”
Can you offer any kind of conjecture over how often a nasal cancer is discovered by accident via rhinoplasty?
“Very rare. It’s unlikely to be seen again in my practice, and I see many rhinoplasty patients. Skin cancer on the nose, however, is much more common. Skin cancer of the nose/face is more likely seen in older patient population.”
Thinking of Having a Nose Job?
There is no need to panic that the surgeon might discover a cancerous tumor in your nose. You should feel at ease upon entering the office for your preop exam.
Just how rare are paranasal tumors?
Only about 2,000 cases of malignant tumors of the sinus area are diagnosed each year in the U.S.