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Let's look at some of the information about

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minor salivary gland tumors and specifically

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Adenoid Cystic Carcinoma, which accounts for

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about five to 8% of all sinonasal cancers.

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The Adenoid Cystic Carcinoma

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accounts for 68.1% of those.

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Malignancies of the minor salivary

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gland that have perineural spread.

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PNS adenocarcinoma and mucoepidermoid carcinomas,

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which also are minor salivary gland tumors

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have a much lower rate of perineural spread.

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The minor salivary gland adenoid cystic carcinoma is

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more common in the maxillary sinus than nasal cavity.

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Much like squamous cell carcinoma and

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has that 50 to 60% rate of perineural

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spread of the adenoid cystic carcinomas.

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The second most common is going to be adenocarcinoma.

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This is, again, more common in the ethmoid sinus,

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and then the mucoepidermoid carcinomas, which may

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occur in the maxillary sinus or nasal cavity.

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We're going to also talk a little bit about some

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of the more aggressive carcinomas, which includes

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S sinonasal undifferentiated carcinoma, as well as

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the nuclear protein in testis or NUT carcinoma

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that also occurs in the sinonasal cavity.

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In addition, there are different sarcomas that

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can occur in the sinonasal cavity in children.

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The most common of these malignancies is

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going to be the rhabdomyosarcoma,

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of which the renal form is most common.

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The sinonasal cavity is number four in the head and neck

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for the presence of rhabdomyosarcoma after the orbit.

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The nasopharynx and the temporal bone and ear rhabdo.

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Sarcomas have a propensity for metastatic

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disease and the tumor itself may be hemorrhagic

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when it spreads in the parameningeal location.

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It has a worse prognosis.

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However, there have been recent developments in

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chemotherapy and immunotherapy that make rhabdomyosarcoma

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a relatively good prognosis of all those

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sarcomas that can occur in the head and neck.

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Here, for example, is a patient who had

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a maxillary sinus rhabdomyosarcoma, which

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grew through the skull base and shows this

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large amount of extradural enhancement.

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You could see a little dural tail associated with

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this enhancing rhabdomyosarcoma in the child.

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Another of the sarcomas is

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the low-grade chondrosarcoma.

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This occurs in the head and neck and in the sinonasal

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cavity, particularly around the nasal septum.

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However, outside the sinonasal cavity,

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we find these in the petroclival, senal

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occipital, and frontal nasal synchondroses.

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So wherever you have that cartilaginous

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deposition, you may have a chondrosarcoma.

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This is a tumor which I've shown you previously

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with a chondrosarcoma, which has a matrix

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that is more popcorn, calcified appearance.

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It may be very bright on the T2-weighted

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scan, and therefore as a malignancy that's

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typically in the midline, in the sinonasal cavity.

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You may be able to make that suggestive diagnosis.

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The treatment is wide surgical excision.

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Because it's usually centered on the nasal septum,

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usually does not have as wide growth as you would

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expect with other malignancies in this location.