WHO Classification of Head and Neck Tumours

285 Pages·2017·114.312 MB·English

by  Adel K. El-Naggar, John K. C. Chan, Jennifer R. Grandis, Takashi Takata, Pieter J Slootweg

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Contents
Tumours of the nasal cavity, paranasal sinuses and 11 Introduction
65
Nasopharcyanrgceianlo ma
skull base
65
Nasopharpyanpgielaaldlae rnyo carcinoma
WHOa ndT NMc lassifications 12
70
Introduction 14 Salivartyu mgoluarnsd
71
Adenociydsc taircc inoma
Carcinomas 14
71
Saligvlaaranynd l atguem our
Keratinsiqzuianmcgoe uclsal r cinoma 14
71
Benignb oarndde rline lesions
Non-kerastqiunaimzcoieucnlsagl r cinoma 15
72
Spincdel(lesl a rcomsaqtuoaimdco)euc lsal r cinom1a7 Hairy polyp
72
Ectoppiitcu aidteanroym a
Lymphoepciatrhceilnioamla 18
72
Sinonuansdailf ferceanrtciiantoemda 18 Craniopharyngioma
73
NUTc arcinoma 20 Soft ttuimsosuures 74
Neuroendcoacrrciinneo ma 21 Nasopharaynnggieoafli broma 74
Adenocarcinoma 23 Haematolymphoid tumours 75
Intestiandaeln-otcyaprec inoma 23 Notochordal tumours 76
Non-intesatdiennaolc-atrycpien oma 24 Chordoma 76
Teratocarcinosarcoma 26
Sinonpaaspaill lomas 28 3 Tumours of the hypopharynx, larynx, trachea and
Sinonpaaspaill ilnovmeatr,yt peed 28 parapharyngeal space
Sinonpaaspaill olnocmoac,ty ytpiec 29 WHOa nTdN Mc lassifications 78
Sinonpaaspaill elxoompah,ty ytpiec 30 Introduction 81
Respiratory epithelial lesio3n1s Maligsnuarnftea pciet hteulmioaulr s 81
Respireaptiotrhayed leinaolm haatmoairdt oma 31 Conventsiqounaamcloe uclsal r cinoma 81
Seromuchianmoaurst oma 32 Verruscqouuasm coeuclsal r cinoma 84
Saligvlaartnyud m ours 33 Basaloid cseqclualar mcoiunso ma 85
Pleomoardpehniocm a 33 Papilslqauraymc oeuclsal r cinoma 87
Maligsnoatfnitts tsuumeo urs 34 Spincdelsleql u amcoeuclsal r cinoma 87
Fibrosarcoma 34 Adenosqucaamrocuisn oma 89
Undifferpelnetoimaostraeprdhc iocm a 35 Lymphoepciatrhceilnioamla 90
Leiomyosarcoma 35 Preculressoiro ns 91
Rhabdomyosarcoma 36 Dysplasia 91
Angiosarcoma 38 Squamcoeuplsal p il&ls oqmuaa mcoeuplsal p oimlalto93s is
Maligpnearnitp nheerrsvahele attuhm our 39 Neuroendtoucmroiunres 95
Biphensoitnyopnisacas raclo ma 40 Well-diffneeruernoteinadctoaecrdrc iinneo ma 95
Synosvairaclo ma 41 Moderadtieflfye rennetuiraoteenddc oacrrciinneo 96m a
Bordnee/rl loiw-gmraaldieg snoatfnitts tsuumeo urs 43 Poodrilyf ferennetuiraoteenddc oacrrciinneo ma 97
Desmoidf-itbyrpoem atosis 43 Saligvlaartnyud m ours 99
Sinongalsoamla ngiopericytoma 44 Adenociydsc taircc inoma 99
Soliftiabrrtyou umso ur 45 Pleomoardpehniocm a 99
Epithhealeimoaindg ioendothelioma 46 Oncocyticc ypsatpaidlelnaormya 99
Benisgontf its tsuumeo urs 47 Sotfits tsuumeo urs 100
Leiomyoma 47 Granucletalurlm our 1()0
Haemangioma 47 Liposarcoma 1()0
Schwannoma 48 Inflammmyaotfoirbyr toubmloausrt ic 110
Neurofibroma 49 Cartitluamgoeu rs 102
Othteurm ours 102
50 Chondraonmcdah ondrosarcoma
Meningioma 50 Haematolytmupmhoouirds 104
Sinonaamseallo blastoma 51
Chondromesehnacmhayrmtaolm a 51 4 Tumours of the oral cavity and mobile tongue 105
Haematolytmupmhoouirds 106
52 WHOa ndT NMc lassifications
Overview 108
52 Introduction
ExtraNnKo/dfa-llcy emlplh oma 109
NeEuxrtoreacotps/omls deaeelsoramumnasaoc tlcyu ytmtooimucar s 555426 OMraSalpqlioun gtastenmuiacormaneufaltcelsall apl ciyri eg tcd nhiiaesnnlootirm& adao el rr eastpl uie mtllohdi uysapralsi.sa 11109 2
MOEulwcfisoanmascgnerat elc!ouao rrnmyooa bm/lapna resiutmroiomteaic vtteou dmeorumrasl 655 076 POOrrr�foaaep ellpo�e�r1 1enat_alvttlldei1mlayrvaylsrel pu illcgeoadnuusiaksisno aotp r ldaekrisa 11;111153 22
Papialsl om
2 Tumours of the nasopharynx 115
WHOa nTdN Mc lassifications 63 Squamcoeuplsal p illoma 116
64 Condylaocmuam inatum
Verrvuuclag arls 117 Introduction 162
Multiefpoictahhlye pleirapll asia 117 Maligtnuamnotu rs 163
Tumoouufrn sc erhtiasitno genesls 119 Mucoepldcearrmcoilndo ma 163
Congegnriatnaculel elaplru lis 119 Adencoyisdct aircc inoma 164
Ectomesecnhcohnydmraoltm uymxoouird 119 Aclcnelclcal r cinoma 166
Sotfits asnundee utruamlo urs 121 Polymorapdheonuosc arclnoma 167
Grancueltlaulrm our 121 Clecaercl alr cinoma 168
Rhabdomyoma 122 Bascaelal dle nocarclnoma 169
Lymphangioma 122 lntracdaurcctianlo ma 170
Haemangioma 123 AdenocarNcOlSn oma, 171
Schwanannondme au rofibroma 123 Salidvuaccrtay r cinoma 173
Kapossair coma 124 Myoeplctahrecliinaolm a 174
Myofibrsoabrlcaosmtai c 125 Eplthelialc-amrycoienpolmtah ellal1 75
Ormalu comseal!a noma 126 Carcienxpo lmeao moardpehnlocm a 176
Salitvyaptreuy m ours 127 Secrectaorrcyi noma 177
Mucoepidcearrmcoiindo ma 127 Sebacaedoeunso carclnoma 178
Pleomoardpehniocm a 127 Carcinosarcoma 179
Haematolymphoid tumours 128 Poodrilfyf erceanrtciiantoemda 180
Overview 128 Lymphoepclatrhceilnloamla 181
CD30-poTs-iclteyilmvlpe h oprodli.oisrfdeerra t1i2v9e Squamcoeuclsal r cinoma 182
Plasmabllyamsphtoimca 129 Oncoccyatricci noma 182
Langerchehalinlss t iocytosis 130 Slaloblastoma 183
Extramemdyuellsloaairrdcy o ma 131 Benitgunm ours 185
Pleomoardpehniocm a 185
5 133 Myoepithelioma 186
Tumouorfts ho er opharynx
Bascaelal dle noma 187
(baosfte o ngtuoen,sa idlesn,o ids)
WHOa nTdN Mc lassifications 134 Wartthuimno ur 188
Introduction 136 Oncocytoma 189
Squamcoeuclsal r cinoma 136 Lymphadenoma 190
Squamcoeuclsal r cinoma, HPV-pos1i3t6i ve Cystadenoma 191
Squamcoeuclsal r ciHnPoVm-an,e gative 138 Sialadpeanpoimlal iferum 192
Saligvlaarnyd tumours 139 Ductal papillomas 192
Pleomoardpehniocm a 139 Sebacaedoeunso ma 193
Adencoyisdct aircc inoma 139 Canalaidceunloaamrnoa dt hdeurc atdaeln omas 194
Polymorapdheonuosc arcinoma 140 Non-neoeppliatslhteeislcii oanls 195
Haematoltyummpohuorisd 141 Sclerpoosliyncagyd setniocs ls 195
Introduction 141 Noduolnacro chyytpiecr plasia 195
Hodglkyimnp homa 141 Lymphoepslitahlealdieanll tls 196
Burlkyimtpth oma 142 Intercdaulchatyt peedr plasia 197
Follicular lymphoma 143 Benign sloefsti otniss sue 198
Manctellleyl m phoma 144 Haemangloma 198
T-lymphloebulkaasetmiica /lymphoma1 44 Llpoma/sialolipoma 198
Folldiecnudlcraeirslt alir cc oma 145 Nodular fasclltls 199
Haematoltyummpohuorlsd 200
6 147 Extranodazlo nlmeya mrpghioonfmma ualc osa-
Tumoaunrtdsu mourl-elsiikoen s
assocliyamtpehtdoi is(dsM uAelL yTm phoma) 201
oft hnee cakn ldy mnpohd es
WHOc lassification 148
Introduction 148 8 Odontogemnaxllcl laonbfdoa nctelu amlo urs 203
Tumooufur nsk nown origin 150 WHO cliacsastllfo n 204
Carcionfuo nmkan porwinm ary 150 Introduction 205
Merckeeclla lr cinoma 151 Odontocgaernclicn omas 206
Heterotopicaa-racsisnoocmiaa ted 152 Amelobclaarsctiinco ma 206
Haematoltyummpohuorisd 154 Primlanrtyr aocsasrecoiunso ma, NOS 207
Cystsc yasntld-e lsiikoen s 155 Scleroodsolnntgoc gaernclicn oma 209
Brancchliceayflst t 155 Clearo dcoenltloc gaernclicn oma 210
Thyroglossal duct cyst 156 Ghocsetol dlo ntocgaernclicn oma 211
Ranula 156 Odontogenlc carclnosarcoma2 13
Dermaonitdde ratoid cysts 157 Odontosgaernclocm as 214
Beniegpni tohdeolnitaolt guemnolucr s 215
159 Ameloblastoma 215
7 Tumrosou fs aligvlaarnyd s
WHOa nTdN Mc lassifications 160 Amelobluansltcotymysapt,el c 217
Ameloblastoma, extraosseous/peripheral type 218 9 Tumours of the ear 261
Metastasizing ameloblastoma 218 WHO classification 262
Squamous odontogenlc tumour 219 Introduction 263
Calcifying epithelial odontogenic tumour 220 Tumours of the external auditory canal 263
Adenomatoid odontogenic tumour 221 Squamous cell carcinoma 263
Benign mixed epithelial & mesenchymal odontogenic tumours 222 Ceruminous adenocarcinoma 264
Ameloblastic fibroma 222 Cerumlnous adenoma 265
Primordial odontogenic tumour 223 Tumours of the middle and inner ear 266
Odontoma 224 Squamous cell carcinoma 266
Dentinogenic ghost cell tumour 226 Aggressive papillary tumour 266
Benign mesenchymal odontogenic tumours 228 Endolymphatic sac tumour 267
Odontogenic fi broma 228 Otosclerosis 268
Odontogenic myxoma/myxofibroma 229 Cholesteatoma 269
Cementoblastoma 230 Vestibular schwannoma 207
Cemento-ossifying fibroma 231 Meningioma 271
Odontogenic cysts of inflammatory origin 232 Middle ear adenoma 272
Radicular cyst 232
Inflammatory collateral cysts 233 10 Paraganglion tumours 257
Odontogenic and non-odontogenic developmental cysts 234 WHO classification 276
Dentigerous cyst 234 Introduction 276
I Odontogenic keratocyst 235 Carotid body paraganglioma 277
Lateral periodontal cyst and botryoid odontogenic cyst 236 Laryngeal paraganglioma 281
Gingival cysts 238 Middle ear paraganglioma 282
Glandular odontogenic cyst 238 Vagal paraganglioma 283
Calcifying odontogenic cyst 239
f'
Orthokeratinized odontogenic cyst 241 Contributors 285
Nasopalatine duct cyst 241
I Malignant maxillofacial bone and cartilage tumours 243 Declaration of interests 292
Chondrosarcoma 243 IARC/WHO Committee for ICD-0 293
Mesenchymal chondrosarcoma 244 Sources of figures 294
Osteosarcoma 244 Sources of tables 297
Benign maxillofacial bone and cartilage tumours 246 References 298
I Chondroma 246 Subject index 340
Osteoma 246
List of abbreviations 347
Melanotic neuroectodermal tumour of infancy 247
Chondroblastoma 248
l
Chondromyxoid fibroma 249
1-
Osteoid osteoma 249
Osteoblastoma 249
Desmoplastic f ibroma 250
Fibro-osseous and osteochondromatous lesions 251
Ossifying fibroma 251
Familial gigantiform cementoma 253
Fibrous dysplasia
253
Cemento-osseous dysplasia
254
Osteochondroma
255
Giant cell lesions and simple bone cyst
256
Central giant cell granuloma
256
Peripheral giant cell granuloma
257
Cherubism
257
Aneurysmal bone cyst
258
Simple bone cyst
259
Haematolymphoid tumours
260
Solitary plasmacytoma of bone
260
CHAPTER 1
Tumourosft hen asacla vitpya,r anasal
sinusaensd s kulbla se
Squamocuecsla lr cinomas
Lymphoepictahrecliinaolm a
NUTc arcinoma
Neuroendcoacrrciinneo mas
Adenocarcinomas
Teratoncoasracric oma
Sinonpaaspaill lomas
Respireaptiotrhlyee lsiiaoln s
Saligvlaartnyud m ours
Maligsnoatfnitts tsuumeo urs
Borderlloiwn-eg/mr aaldieg nant
sotfits tsuumeo urs
Benisgontf its tsuumeo urs
Haematolytmupmhoouirds
Neuroect/om deelramnaoltc uymtoiucr s
WHOc lassifoiftc uamtoiuoornfts h nea scaalv ity,
paransaasli nusaensds kublals e
Carcinomas Borderlloiwn-egm/ra aldieg snoatfnitts tsuumeos u r
Keratinizing squamous cell carcinoma 8071/3 Oesmoid-type fibromatosis 8821/1
Non-keratinizing squamous cell carcinoma 8072/3 Sinonasal glomangiopericytoma 9150/1
Spindle cell squamous cell carcinoma 8074/3 Solitary fibrous tumour 8815/1
Lymphoepithelial carcinoma 8082/3 Epithelioid haemangioendothelioma 9133/3
Sinonasal undifferentiated carcinoma 8020/3
NUT carcinoma 8023/3* Benisgontft i stsuumeo urs
Neuroendocrine carcinomas Leiomyoma 8890/0
Small cell neuroendocrine carcinoma 8041/3 Haemangioma 9120/0
Large cell neuroendocrine carcinoma 8013/3 Schwannoma 9560/0
Adenocarcinomas Neurofibroma 9540/0
Intestinal-type adenocarcinoma 8144/3
Non-intestinal-type adenocarcinoma 8140/3 Othteurm ours
Meningioma 9530/0
Teroactarcinosarcoma 9081/3 Sinonasal ameloblastoma 9310/0
Chondromesenchymal hamartoma
Sinonpaaspaill lomas
Sinonasal papilloma. inverted type 8121/1 Haematohloyitmdup mours
Sinonasal papilloma, oncocytic type 8121/1 Extranodal NK/T-cell lymphoma 9719/3
Sinonasal papilloma, exophytic type 8121/0 Extraosseous plasmacytoma 9734/3
Respireaptiotrhlyee lsiiaoln s Neuroect/o mdeelramnaolc ytic tumours
Respiratory epithelial adenomatoid hamartoma Ewing sarcoma/ primitive neuroectodermal
Seromucinous hamartoma tumour 9364/3
Olfactory neuroblastoma 9522/3
Saligvlaartnyud m ours Mucosa! melanoma 8720/3
Pleomorphic adenoma 8940/0
Maligsnoatfnitts tsuumeo urs
Fibrosarcoma 8810/3
Undifferentiated pleomorphic sarcoma 8802/3
Leiomyosarcoma 8890/3
Rhabdomyosarcoma, NOS 8900/3
Embryonal rhabdomyosarcoma 8910/3
Alveolar rhabdomyosarcoma 8920/3 Thmeo rphocloodgaeyrs fe r otmhI en ternCaltaisosniafolifD c iasteaisoens
foOrn col(oIgCyD 1-707)6 BAe)h.a viisco oudre/ d0f obre nitgunm ours;
Pleomorphic rhabdomyosarcoma, adult type 8901/3 /1f ourn specbiofrideedor,rlu inncee,rb teahianv /i2fo oucrra ;r ciinno ma
Spindle cell rhabdomyosarcoma 8912/3 siatnugd r aIdlienl t raepnietohpelalanis/dai3 lfa o;mr a ligtnuamnotu rs.
Angiosarcoma 9120/3 Thcel assiifmsio cdaitffiiorenotd mhp er eviWoHuOc sl assiftiackaitnigo n,
inatcoc ocuhnatn gienos uu rn derstoaftn hdeisneg lesions.
Malignant peripheral nerve sheath tumour 9540/3
'Thenseewc odweesr aep probvyte hdIe A RC/WHCOo mmiftotIreC eD -0.
Biphenotypic sinonasal sarcoma 9045/3*
Synovial sarcoma 9040/3
12 Tumours of the nasal cavity, paranasal sinuses and skull base
-
TNM classification of carcinomas of the nasal cavity and
paranasal sinuses
"NMc lassia.fbi cation
N -Regional lymph nodes (I.e. the cervical nodes)
P1 matryu mour NX Regiolnyamlnp ohd ceasn nboeat s sessed
Primtaurmyoc uarn nboeat s sessed NO Nor egiloynmanploh d mee tastasis
O Noe videonfpc rei mtaurmyo ur N1 Metasitnaas siinsig plsei llaytmenprohad l�e ,c3m i n
T" s Carcinionsm iat u greadtiemsetn sion
N2 Metasatsas spiesc iifnNi 2eaNd,2 bo,rN 2cb elow
Maxalryls linus N2a Metasitnaas siinsig plsei llaytmenprohad l>e ,c3 m b ut
T1 Tumoluirm ittote haden tmruaclo swai,tnh oe rosoiro n :S c6m i ng reatest dimensfon
destruocfbt oinoen N2b Metasitnma uslitsii ppsliel laytmenprohad lea sl:S,l9 c m
T2 Tumocuaru singe rboosonirdeo e ns truicntcilound,i ng ing readtiemsetn sion
extenisnihtoaonr p da laantde/ moird dnlaesm aela tus, N2c Metasitnba isliasot rce ornatlr alatneordaelas l,ll ymph
exceepxtt entsopi oosnt ewraioloflmr a xilslianarunysd � c6m i ng readtiemsetn sion
pterypgloaitde s N3 Metasitnaal syimsnp ohd >e c6m i ng readtiemsetn sion
T3 Tumoiunrv aadneoysft hfeo llobwoinonefgp :o sterior
NotMei:d lniondeea src eo nsidieprseidl ateral nodes.
waolflm axilslianrsuyus b,c utatniesosufusle oosor,r
mediwaalol flo rbpitte,r yfgoosiesdta h,m soiindu ses
T4a Tumoiunrv aadneoysft hfeo lloawnitnegor:ri boirt al M D-istmaentta stasis
contesnktiosnfc, h eepkt,e rypgloaitiden sf,r atemporMaOl Nod istmaentta stasis
foscsrai,b rpilfaostrpemh, e noorfi rdo snitnaul ses M1 Distmaentta stasis
T4b Tumoiunrv aadneoysft hfeo lloowribniagtp:ae dlxu ,r a,
bramiind,d clrea nfioaslcs raa,n niearlvo etsht ehram na x­ Staggreo uping
illdairvyio sfti roing enmeirn(vaVel2 n )a,s ophacrlyinvxu,s StaOg e Tis NO MO
StaIg e T1 NO MO
Nasal cavity and ethmoid sinus StaIgIe T2 NO MO
T1 Tumoluirm ittooe ndse u bsoifnt aes caalv oiret tyh moid StaIglel T 1-2N 1 MO
sinwuisto,hr w ithboounityn vasion T3 N0-1 MO
T2 Tumoiunrv otlwvsoeu sb siintas e isn sgiloteree x tetnod s StaIgVeA T 1-3N 2 MO
invoalnav dej acseiwntitet thhinena soethmoidal T4a N0-2 MO
complweixto,hrw ithboounityn vasion StaIgVeS T 4b AnNy MO
T3 Tumour etxoit nevnatddhsmee e diwaalol rlf loooftr h e AnyTN 3 MO
orbmiatx,i lslianruys , orpc arliabtrpeil,fa otrem StaIgVeC AnyTA nyN M1
T4a Tumoiunrv aadneoysft hfeo lloawnitnegor:ri boirt al
contesnktiosnfn, o soerc heemki,n iemxatle ntsoi on
•AdapftreoEdmd geeta ll.6 25-Auls ewdi tphe rmisosfti hAoemn e rican
antecrriaonIrio aslps tae,r ypgloaitsdep sh,e noori d
JoiCnotm miotntC eaen c(eArJ CCCh)i.c aIglol,it nhooeri isg;ai nnpdar li ma­
frosnitnauls es rys ourfcoterh iinsf ormiastth AieJo CnCC a ncSetra gMianngu Saelv,e nth
T4b Tumoiunrv aadneoysft hfeo lloowribnaigpt:ea dxlu, r a, Edit(i2o0n1p 0u)b libsySh perdi Sncgieern ce+BMuesdiinaaen-sdSs o bin
bramiind,d clrea nfioaslcs raa,n niearlvo etsht ehraV n2 , eta l{.2 228Al.
0Ah eldpe sfkos rp ecqiufeisct aiboonTusNt M c lassiifasi vcaaitliaaotbn l e
nasophacrlyinvxu,s
http://www.uicc.org/resources/tnm/helpdesk.
TNM classification of carcinomas of the nasal cavity and paranasal sinuses 13
Tumoruso ft hneas acla tvyip,aa rnasal
siunsesa nsdku lbla se
Introduction carcinoma with adenoid cystic-like fea­ carcinoma, and that there may be some
tures is provisionally listed as a subtype overlap between tumours, such as be­
Slootweg P.J. of non-keratinizing squamous cell carci­ tween some sinonasal undifferentiated
Chan J.K.C. noma, with additional data needed to jus­ carcinomas and high-grade neuroendo­
Stelow E.B. tify full recognition as a unique entity. Tu­ crine carcinomas. More data are needed
Thompson L.D.R. mours of bone and cartilage, which were before recommendations can be made
included in both the jaw and sinonasal on how best to classify tumours within
tract chapters in the previous edition, are these categories. In the meantime, we
The sinonasal tract (i.e. the nasal cav­ in this edition discussed exclusively in have tried to remain consistent with pre­
ity and . associated paranasal sinuses) Chapter 8 ( Odontogenic and maxillofacial vious classification systems of tumours
is the site of origin for a wide variety of bone tumours, p. 203) -a more appropri­ both at this site and at others (e.g. the
neoplasms. The entities included in this ate approach given their morphological classification of high-grade neuroendo­
chapter meet one of three inclusion crite­ overlap with some odontogenic tumours. crine carcinomas of the lung).
ria: (1) they occur exclusively in the sino­ The role of immunohistochemical and Within the sinonasal tract, CT is primarily
used to evaluate mass effect on adjacent
nasal tract, (2) they occur at other head genetic features in tumour characteriza­
and neck sites but show a predilection tion is reported with a balance between osseous structures, whereas MRI is bet­
for the sinonasal tract, or (3) they are im­ worldwide global application and the use ter for distinguishing mucosa! thickening
portant in the sinonasal ract for differen­ of more expensive diagnostic methods and fluid resulting from a pathological
tial diagnostic reasons. The first group is not everywhere available, in an effort to mass process. Thus, these imaging mo­
discussed extensively and the other two ensure a more universal applicability of dalities are complementary techniques.
more concisely, with the reader referred the classification. However, in general, cross-sectional im­
to other chapters for additional informa­ It is noted that some tumours may consti­ aging findings are not unique or tumour­
tion. This edition includes NUT carcino­ tute a spectrum of entities, such as high­ specific; therefore, information regarding
ma and biphenotypic sinonasal sarcoma grade non-intestinal-type adenocar­ imaging findings is included only when it
as well-defined new entities. HPV-related cinoma and sinonasal undifferentiated is of specific diagnostic value.
Carcniomsa
Keratinizing squamous cell Synonym
carcinoma Epidermoid carcinoma
Bishop J.A. Epidemiology
Bell D. Sinonasal KSCCs are rare, and the sino­
Westra W.H. nasal tract is the least common head and
neck subsite involved by squamous cell
carcinoma (SCC) (82). KSCC most often
Definition
affects patients in their sixth to seventh
Sinonasal keratinizing squamous cell decades of life, and men are affected
carcinoma (KSCC) is a malignant epi­ twice as often as women (82,2065,2438}.
thelial neoplasm arising from the surface
epithelium lining the nasal cavity and Etiology
paranasal sinuses and exhibiting squa­ Cigarette smoking increases risk, al­
mous differentiation. though less dramatically than in other
head and neck sites {271,960,1458,
ICD-0 code 8071/3 2688). Wood dust, leather dust, and other
14 Tumours of the nasal cavity, paranasal sinuses and skull base