SINONASAL CANCER

ALTERNATE NAMES

Sinonasal Malignancy; Sinonasal Undifferentiated Carcinoma; SNUC; Highly Aggressive Undifferentiated Carcinoma of the Nasal Cavity and Paranasal Sinuses

DESCRIPTION

Sinonasal Cancer is a rare aggressive cancer of the nasal cavity or the paranasal sinuses. This cancer is often confused with other poorly differentiated carcinomas that begin in the sinonasal tract. These tumors mimic signs of sinusitis and have symptoms of nasal discharge (bloody or runny nose), nasal obstruction, and difficulty breathing through the nasal cavity, pressure in the mid-face, double vision, bulging eyes, and chronic infections.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING

Diagnostic testing: Immunohistochemistry of biopsy; MRI or CT scans; PET scan; electron microscopy; and molecular biologic studies are used to diagnosis SNUC.

Physical findings: Physical findings may show a mass on the nasal cavity, ophthalmologic examination with eye papilledema (swelling of the optic disc) and proptosis (forward displacement of the eye), and diplopia (double vision).

ICD-9: 160.0 – 160.9

ONSET AND PROGRESSION

People with sinonasal malignancy usually present with advanced stage tumors following a rapid onset of symptoms. The prognosis of SNUC is poor once the cancer invades the skull and brain. Survival after treatment with chemotherapy and radiation is generally less than one year.

TREATMENT

By the time this type of cancer is diagnosed, the tumor is usually clinically advanced and surgically unresectable. Treatment for sinonasal cancers involves multimodal therapy including surgical resection, and adjuvant therapy (i.e. chemotherapy, and radiation).

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for evaluation:

• Clinical history and examination that describes the diagnostic features of the impairment.

• Pathology report documenting type and stage of tumor.

• Operative reports.

• MRI or CT scans.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets Listing

13.02 A, B,C,D or E

Listing level severity must be documented.

Medical Equals