Maxillary sinus carcinoma (staging)

Maxillary sinus carcinoma staging refers to TNM staging of epithelial malignancies involving the maxillary sinus. Applicable histologies include squamous cell carcinoma, adenocarcinoma, sinonasal undifferentiated carcinoma, and other rarer carcinomas. The following article reflects the 8^th version manual published by the American Joint Committee on Cancer, which is used for staging starting January 1, 2018 ^1,2.

Primary tumor (T)

• TX: primary tumor cannot be assessed

• Tis: carcinoma in situ

• T1: tumor limited to maxillary sinus mucosa (no bone erosion/destruction)

• T2: tumor with bone erosion/destruction, including extension into hard palate and/or middle meatus, excluding structures in a higher T category

• T3: tumor invades any of the following:

  • bone of posterior wall of maxillary sinus

  • subcutaneous tissues

  • floor or medial wall of orbit

  • pterygoid fossa

  • ethmoid sinuses

• T4: moderately advanced or very advanced local disease

  • T4a: moderately advanced local disease in which tumor invades any of the following:

    • anterior orbital contents

    • skin of cheek

    • pterygoid plates

    • infratemporal fossa

    • cribriform plate

    • sphenoid sinus

    • frontal sinus

  • T4b: very advanced local disease in which tumor invades any of the following:

    • orbital apex

    • middle cranial fossa

    • dura

    • brain

    • cranial nerves other than maxillary division of trigeminal nerve (V2)

    • nasopharynx

    • clivus

Regional lymph node (N)

Regional nodal status is defined the same as for most other cancers of the head and neck. See the main article, cervical lymph node (staging).

Distant metastases (M)

The terms pM0 and MX are not valid TNM categories. The following categories may be used:

• cM0: no evidence of metastases

• cM1: distant metastasis

• pM1: distant metastasis, microscopically confirmed

Stage groups

The prognostic stage groups are defined the same as for most other cancers of the head and neck:

• stage 0

  • Tis, N0, M0

• stage I

  • T1, N0, M0

• stage II

  • T2, N0, M0

• stage III

  • T3, N0, M0

  • [T1, T2, T3], N1, M0

• stage IVA

  • T4a, [N0, N1], M0

  • [T1, T2, T3, T4a], N2, M0

• stage IVB

  • [Any T], N3, M0

  • T4b, [Any N], M0

• stage IVC

  • [Any T], [Any N], M1

See also

• nasal cavity and ethmoid sinus carcinoma (staging)

• sinonasal mucosal melanoma (staging)

• WHO classification of head and neck tumors

• cervical lymph node levels

• cervical lymph node staging