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Clinocpathological study of tumours of maxilla

Background: Malignant neoplasms of the nose and paranasal sinuses are rare and account for 3% of malignancies involving head and neck region. Maxillary sinus is the commonest area affected and squamous cell carcinoma is the commonest malignancy reported. Due to nonspecific clinical features, late presentations and poor accessibility tumours in these areas are both therapeutically and diagnostically challenging. Data about maxillary sinus tumours, especially from Karaikal are lacking. This prospective hospital-based study was conducted to determine the common benign and malignant tumours affecting the maxilla, their epidemiology and to analyse their clinical presentations. Methods: Relevant epidemiological and clinical details were collected for all the patients with maxillary tumours and thorough clinical evaluation was performed. CT scan of head and neck region and histopathological examination of the lesion was carried out. All the details were tabulated and percentages were calculated for comparison and analysis. Results: During two years period of the study 44 patients with tumours affecting the maxilla were detected, 32 (72%) being benign and 12 (27%) malignant. Incidence of both benign and malignant tumours was highest in the 51-60 years age group with male preponderance. Squamous cell carcinoma (58.33%) was the most common malignant histological variant found while inverted papilloma with squamous epithelium (62.5%) was the most common benign histological variant. In TNM staging, 42% patients had T4 and the remaining were T3 and T2. Conclusions: In Karaikal region, inverted papilloma with squamous epithelial lining and squamous cell carcinoma are the commonest benign and malignant tumours of maxilla respectively. Although clinical manifestations of both benign and malignant lesions overlap, certain features like facial pain, cheek swelling, loosening of teeth which were found only in association with carcinoma should warrant thorough evaluation.