Nasal Malignancy
This guideline applies to adults aged 18 years and over.
Introduction
Sinonasal malignancy is cancer affecting the nasal cavity and sinuses. It is rare in the UK with around 460 cases diagnosed each year1.
Nasopharyngeal cancer affects the junction between the nasal cavity and pharynx. It is also rare, with around 240 cases diagnosed each year in the UK2.
Most nasal symptoms can be explained by common conditions, such as rhinosinusitis, allergic rhinitis and nasal polyposis.
Key Features of Assessment
Red flag features
Nasal cancer should be excluded in the context of new onset, persistent and/or rapidly progressive:
- Unilateral facial pain and/or swelling
- Unilateral epistaxis or crusting with nasal obstruction – simple epistaxis is typically unilateral at presentation
- Clear watery nasal discharge (CSF leak presents like a dripping tap)
- Bulging eye associated with visual disturbance, painful eye movements and/or double vision
- Dental changes e.g. loosening of upper teeth
Risk factors for nasal malignancy
Investigations
No investigations are required or recommended prior to referral.
Advice and Guidance
Refer any suspected nasal malignancy via ENT Advice and Guidance – the consultant will consider the clinical information and advise regarding appropriate prioritisation and urgency of referral.
Do not send via Fast Track ENT Suspected Cancer or urgent ENT OPA.
References
- UCL NHS Foundation Trust – Nasal (nose) and sinus cancer
- UCL NHS Foundation Trust – Nasopharyngeal cancer
Page Review Information
|
Review date |
05/04/2024 |
|
Next review date |
05/04/2026 |
|
GP speciality lead |
Dr Laura Vines |
|
Contributors |
Ms Aileen Lambert, Consultant ENT Surgeon Mr Neil Tan, Consultant ENT Surgeon |