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Imaging findings of malignant tumors originated from frontal sinuses |
PAN Yu-cheng, HUANG Wen-hu |
Department of Radiology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai 200031, China |
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Abstract Objective: To explore the CT and MRI findings of the primary malignant tumors of the frontal sinus, in order to improve the clinic diagnosis of these diseases. Methods: The imaging data of 14 patients with pathologically proved malignant tumors were analyzed retrospectively, including 5 squamous carcinomas(one of which cancerated from inverted papilloma), 3 plasmocytomas, 2 melanomas, 1 rhabdomyosarcoma, 1 small cell carcinoma, 1 osteosarcoma and 1 mesenchymal sarcoma. Eight patients underwent plain CT, 6 patients underwent enhanced CT scan, and 13 patients underwent MRI examinations. Results: Eleven lesions originated from the left frontal sinus, 2 lesions from the right, while one from bilateral sinuses. The lesions invaded orbit walls in 14 cases, ethmoid sinuses in 10 cases, forehead in 7 cases, anterior cranial fossa in 10 cases and contralateral frontal sinus in 3 cases. One lesion was a regular nodule, while the other 13 lesions were irregular or diffused. On plain CT of 8 cases, tumors showed isointensity. After contrast enhancement, four masses were heterogeneously enhanced and two were homogenously enhanced. The tumors eroded the anterior walls of frontal sinus in 7 cases, the posterior walls in 12 cases and inferior walls in 14 cases. On T2WI of MRI, 10 masses showed isointense or slightly hyperintense signal, 2 masses showed mixed isointense and hyperintense signal, 1 mass showed slightly hypointense signal. After contrast enhancement, 10 lesions showed heterogeneous enhancement on T1WI images, three plasmocytomas showed homogenous enhancement. Four masses showed limited diffusion on DWI, and one showed slightly limited diffusion. Conclusion: The most common malignant tumors that originate from frontal sinuses are squamous carcinoma, plasmocytoma and melanoma. The posterior and inferior walls of the frontal sinuses are eroded in most cases. Most lesions invade to the outside of the sinuses, including orbits, ethmoid sinuses and anterior cranal fossae. The masses show limited diffusion on DWI. Plasmocytoma and melanoma have some characteristic MR signals. Combining CT and MRI images is helpful to confirm the characters and ranges of the lesions.
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Received: 10 May 2016
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