[Malignant tumor's of nasal fossae: anatomoclinic's study and a new classification: study about 21 cases].

PURPOSE

This work proposes to study the anatomoclinical, therapeutic and evolutionary characteristics of the malignant tumours of the nasal cavities. This study focuses exclusively on the malignant tumours strictly of the endonasal variety (excluding tumours from the olfactive placode and those extending to the paranasal cavitie). These tumours are not common not often studied in the literature and their is not codified (classification, treatment). A new classification of the malignant tumours (strictly endonasals varieties) is presented in this study.

PATIENTS AND METHODS

This is a retrospective study of 21 malignant tumours of the nasal cavities selected between January 1989 and December 2001. The handling of these tumours rests on a tripod diagnosis: nasal endoscopy-imagery-biopsy. The following parameters are studied: epidemiological, histopathological, clinical, therapeutic and evolutionary.

RESULTS

The average age of our population is 52,4 years with a male sex ratio of 1,3. The nasal obstruction is the principal revealing sign (82%) followed by the epistaxis (14,2%). The septal tumours are the most frequent (10 cases). The histopathological results of our study show the prevalence of the epithelial tumours: epidermoid carcinoma (8/21), adenocarcinoma (2/21) malignant melanoma (2/21). The non-epithelial varieties are dominated by lymphomas (NLH) (8/21). The surgery plays a dominant role in the treatment of these tumours. Most of the tumours were operated on, usually transfacially and often with postoperative radiotherapy. The endoscopic surgery was not valided. Our results show on the one hand the gravity of certain tumoral varieties: malignant melanoma, lymphomas(NHL) and on the other hand the overall unfavourable forecast of these tumours with a mortality rate of 42,8%.

CONCLUSION

The malignant tumours of the nasal fossae, in particular in the specific context of this study (strict endonasal tumours) are rare and their handling is not codified. They are dominated by the epithelial malignant varieties, in particular in their septal localizations. The evolutionary profile is dominated by the loco regional recurrence. The forecast of these tumours is overall bad according to the tumoral stage, especially the histopathological varieties.