RESUMO
The annual incidence rate for paranasal sinus cancer is quite low in Europe at approximately 1 case a year per 100 000 inhabitants. The most frequent site is the maxillary sinus; in some countries such as Spain, however, carcinomas of the ethmoidal sinus complex are more prevalent. Squamous cell carcinoma is the most frequent histological type and adenocarcinoma is the one with the best prognosis. In general terms, the association of surgery and radiotherapy continues to be the optimal therapeutic option. The inclusion of an endoscopic endonasal approach for the treatment of these lesions must be considered in very selective cases. Most authors currently accept invasion of the fat and muscles of the orbital apex and infiltration of the conjunctiva and/or sclera as an absolute indication for orbital exenteration. Lymph node involvement at diagnosis or in the course of the disease is infrequent, so prophylactic lymph node treatment would therefore not be indicated.
Assuntos
Neoplasias dos Seios Paranasais , Terapia Combinada , Endoscopia , Humanos , Estadiamento de Neoplasias , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapiaRESUMO
Los carcinomas de senos paranasales presentan una incidencia baja, aproximadamente un caso al año cada 100.000 habitantes entre la población europea. La localización más frecuente es el seno maxilar, aunque en algunos países como España los carcinomas de etmoides son el grupo más numeroso. El tipo histológico más frecuente es el carcinoma escamoso, y el adenocarcinoma es la variante histológica con mejor pronóstico. En términos generales, la combinación de cirugía y radioterapia sigue siendo la modalidad terapéutica óptima. La inclusión del abordaje endonasal endoscópico en el tratamiento de estas lesiones debe considerarse en casos muy seleccionados. Actualmente, la mayoría de los autores acepta como indicaciones para llevar a cabo una exenteración orbitaria la invasión de la grasa, la musculatura y el ápex orbitario y la infiltración de la conjuntiva y/o esclerótica. La afección ganglionar en el momento del diagnóstico o durante el curso de la enfermedad es poco frecuente, lo que justificaría no tratar las cadenas ganglionares de manera profiláctica
The annual incidence rate for paranasal sinus cancer is quite low in Europe at approximately 1 case a year per 100 000 inhabitants. The most frequent site is the maxillary sinus; in some countries such as Spain, however, carcinomas of the ethmoidal sinus complex are more prevalent. Squamous cell carcinoma is the most frequent histological type and adenocarcinoma is the one with the best prognosis. In general terms, the association of surgery and radiotherapy continues to be the optimal therapeutic option. The inclusion of an endoscopic endonasal approach for the treatment of these lesions must be considered in very selective cases. Most authors currently accept invasion of the fat and muscles of the orbital apex and infiltration of the conjunctiva and/or sclera as an absolute indication for orbital exenteration. Lymph node involvement at diagnosis or in the course of the disease is infrequent, so prophylactic lymph node treatment would therefore not be indicated
