This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on June 6, 2022.
A thorough and accurate cancer diagnosis is the first step in developing a sinus cancer treatment plan. Sinus cancer experts use a variety of tests and tools designed for diagnosing sinus cancer, evaluating the disease and developing an individualized treatment plan. Throughout treatment, the care team uses imaging and laboratory tests to track the size of the tumors, monitor the patient's response to treatment and modify the plan when needed.
Some evaluations designed for diagnosing sinus cancer include those listed below.
Biopsies are performed after computed tomography (CT) scans and magnetic resonance imaging (MRI) tests are completed. A biopsy is used to confirm the presence of cancer in the nasal cavity or paranasal sinus. A sample of tissues or cells is required for a biopsy, which must be collected before treatment begins. Biopsies may also help to measure the aggressiveness of the cancer, and where it originated.
The types of biopsies typically used in diagnosing sinus cancers are listed below.
Incisional biopsy: A small piece of tissue is cut from an abnormal-looking area. If the abnormal region is easily accessed, the sample may be taken at the doctor’s office. If the tumor is located deeper within the sinus, the biopsy may need to be performed in an operating room with anesthesia administered for pain. The sample may also be obtained through a more involved endoscopic or open surgical biopsy.
Excisional biopsy: The entire tumor or lesion is removed from a suspicious area. If the region is easily accessed, the sample may be taken in a physician’s office. If the tumor is deep inside the sinus, an operating room may be required, along with anesthesia for pain. A more involved endoscopic or open surgical biopsy may be necessary.
Fine needle aspiration (FNA): A very thin needle attached to a syringe is used to extract cells from a tumor or lump.
Endoscopic biopsy: Tumors and tissue in hard-to-reach places may be obtained through the use of an endoscope, a thin, lighted tube-shaped tool.
Open biopsy: An open surgical biopsy may be required to access tumors or tissue deep inside the sinuses. This may involve cutting skin and bones around the nose to reach the tumors.
An endoscope may be inserted into the nose so the care team may examine hard-to-see areas such as the nasal and sinus passages, and internal and posterior parts of the nose.
The following imaging tests may help the care team diagnose sinus cancer.
The cross-sectional view provided by the CT scan may help locate abnormalities or tumors in the sinus area. The care team also may use a CT to measure tumor size, to determine if existing sinus cancer is growing or metastasizing into the eye or brain, and assess bony parts of the nasal cavity and paranasal sinus areas. Dye may be used to provide better contrast and image clarity.
An MRI may help study the soft tissue and identify cancers in the paranasal sinuses and nasal cavities. It also may offer insight into whether sinus cancer has spread to the eye or brain.
Next topic: How is sinus cancer treated?