Contralateral Maxillary Sinus Lesions in Patients with Nasal Cavity and/or Paranasal Sinus Carcinoma: Analysis of Computed Tomography Findings

Abstract

Objectives: The incidence of bilateral maxillary sinus carcinoma is very low in patients with primary maxillary sinus carcinoma. However, surgeons should perform careful diagnosis of any contralateral maxillary sinus lesions to avoid missing a second primary maxillary sinus carcinoma. We therefore investigated the computed tomography (CT) findings of the contralateral maxillary sinus in patients with nasal cavity and/or paranasal sinus carcinoma. Methods: Between August 1994 and September 2006, 66 patients (41 male, 25 female; age range, 22 to 85 years; mean age, 56.9 years) with nasal and/or paranasal sinus carcinoma were treated. Preoperative and follow-up CT scans of their contralateral maxillary sinuses were retrospectively reviewed. Results: Of the 66 patients, 26 (39.4%) had rhinosinusitis, 6 (9.1%) had retention cysts, and 33 (50.0%) showed normal findings on CT. One patient (1.5%) had bilateral enhanced mass-like lesions. Both masses were diagnosed histologically as poorly differentiated squamous cell carcinoma. The rhinosinusitis findings included mucoperiosteal thickening, sclerotic bone thickening, hyperdense secretion, and an air-fluid level, in order of decreasing frequency. Twenty-three of the 32 patients with benign lesions were included in the follow-up CT analysis, ranging from 24 to 108 months (mean, 45 months). On the final CT scan, rhinosinusitis was aggravated in 5 of 19 cases and improved in 14 cases, and the size of the retention cyst decreased in 4 cases. During the follow-up period, no definite abnormality suggesting tumor development in the contralateral maxillary sinus was detected. Conclusions: Even though most contralateral maxillary sinus lesions are benign and the incidence of bilateral maxillary sinus carcinoma is very low, second primary maxillary sinus carcinoma should be kept in mind in the differential diagnosis of contralateral maxillary sinus lesions in patients with nasal cavity and/or paranasal sinus carcinoma.