Estudo sócio-demográfico e clinico-patológico de 61 casos de carcinoma de células escamosas de seio maxilar tratados no Instituto Nacional do Câncer no período de 1997 a 2006

Abstract

The Sinonasal tract malignancies, especially those originated in the maxillary sinuses, are a group of relatively rare injuries, but extremely important principally because of the aggressiveness of its development. These injuries represent approximately 0.2 to 0.8% of all malignant tumors, and 3% of cancers of the head and neck region. The squamous cell carcinoma is distinguished as the most common malignancy in this region. In Brazilian literature, there are no studies describing the epidemiologic data of the squamous cell carcinoma of the maxillary sinuses. A preliminary survey of records the National Cancer Institute of Rio de Janeiro showed that, in the period of 10 years (1997-2006), a sample of 220 cases of cancer involving the maxillary sinus were identified, a very significant number compared to those found in the international literature. The present study is a clinical-pathological study of squamous cell carcinomas with the epicenter in the maxillary sinus, seeking to identify the main socio-demographic of patients, data from the clinical presentation of tumors, progression, treatments performed, and the complications observed. All cases of cancer located in the nasal cavity and paranasal sinuses, diagnosed and / or treated in the Section of Head and Neck Surgery of the National Cancer Institute (INCA) - Ministry of Health, located in Rio de Janeiro in the period 1997 to 2006 (ten years), were investigated retrospectively, allowing a minimum of 2 years of follow up. The sample was selected for this study considering malignancies originating in the maxillary sinus measured by the identification of the epicenter of growth and the histopathological diagnosis of squamous cell carcinoma and its variants: verrucous carcinoma, basaloid squamous cell carcinoma, papillary squamous cell carcinoma, Spindle cell carcinoma, squamous cell carcinoma and adenosquamous carcinoma. This study showed that the CCESM with its variants make up 41.5% of tumors of the maxillary sinus, this lesion is the most common of the epithelial tumors and of all tumors originated in the maxillary sinuses. The CCESM often are diagnosed clinically in advanced decades, unilateral, affecting mainly men, leucoderms, between 5th and 7th decades of life with symptoms expressed generally on the face, mouth and nose, reflected by increased volume, pain, nasal obstruction and epistaxis. Also, It was observed that the major therapeutic modalities were surgery combined with radiotherapy, radiotherapy alone, followed by surgery. The main type of complications observed was residual disease (38.8%) and there was a high rate of deaths, which increased from 2 years (79.3%) to 10 years (100.0%), with an overall rate of 84.5%.