Maxillary antral carcinoma

Maxillary antral carcinomas are an uncommon head and neck malignancy. They usually present late despite growing large since they remain confined to the maxillary sinus and produce no symptoms.

Epidemiology

Most commonly affects patients over 45 and has a strong male predilection (M:F = 5:1). Maxillary antral carcinomas are more common in Africa and Asia than in Europe or North America .

Clinical presentation

When do symptoms occur, they include:

• unilateral stiffness and obstruction
• blood-tinged nasal discharge
• proptosis
• diplopia
• pain resembling toothache
• enlargement and ulceration of the palate

Pathology

The underlying histology of maxillary antral carcinomas is variable :

• squamous cell carcinoma (80%)
• adenoid cystic carcinoma (10%)
• adenocarcinoma
• verrucous carcinoma
• malignant melanoma
• sarcoma
• lymphoma
• metastases

Etiology

The exact cause of maxillary antral carcinomas remains unknown, but exposure to wood dust, as well as Epstein-Barr virus (EBV) and human papillomavirus (HPV) infection, have been implicated in its pathogenesis .

Radiographic features

It appears as irregular radiopacity within the sinus, eroding the sinus wall.

Treatment and prognosis

Treatment consists of surgery followed by radiation therapy. Prognosis is extremely poor, with a 5-year survival of ~10% .