ENT Liu Knowledge Base Head & neck tumours · physician reviewed
Sinonasal Cancer · Symptoms & diagnosis

How is sinonasal cancer diagnosed and staged?

Reviewed: 8 November 2026 By: Xiangpeng Liu, MD Topic: Sinonasal Cancer Answer length: short, citable
Quick answer

Diagnosis requires a tissue biopsy read by a head and neck pathologist, supported by endoscopic examination and contrast CT or MRI of the neck; PET-CT is added when nodal or distant spread is suspected. Staging uses the AJCC TNM system and guides whether surgery, radiotherapy, chemoradiotherapy or systemic therapy is the primary treatment.

In detail

Staging is site- and histology-specific (AJCC for nasal cavity/ethmoid and maxillary sinus; separate systems for esthesioneuroblastoma and mucosal melanoma). Extension to the orbit, skull base, cribriform plate, pterygoid region or dura usually indicates advanced T category and determines whether an endoscopic or open craniofacial resection is feasible.

Before radiotherapy, guidelines recommend a dental assessment and extraction of teeth with a poor prognosis inside the radiation field. Ask for this early: it prevents osteoradionecrosis later.

  • Nasal endoscopy with rigid or flexible scopes and photographic documentation
  • Contrast MRI for soft tissue, perineural and skull-base extension; dedicated sinus CT for bone detail
  • Image-planned biopsy (avoid blind biopsy of vascular lesions or encephaloceles) with expert head and neck pathology review
  • Immunohistochemistry for HPV/p16, EBV (EBER), melanoma, lymphoma and neuroendocrine markers as indicated
  • Neck imaging and PET-CT/chest imaging for high-grade or advanced disease; ophthalmology and neurosurgery input when the orbit or skull base is involved
  • Multidisciplinary skull-base tumour board before any resection

What this means in practice: this answer is part of the “Symptoms & diagnosis” section of the Sinonasal Cancer topic. If you are comparing treatment options, also read how to compare a second opinion and which records to send.

Other common questions about sinonasal cancer

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Sources for this answer

  1. NCCN Guidelines for Patients: Head and Neck Cancers National Comprehensive Cancer Network · 2025
  2. Head and Neck Cancers (patient information) US National Cancer Institute · 2025
  3. IARC Monographs on the Identification of Carcinogenic Hazards to Humans (tobacco, areca nut, UV radiation, EBV, HPV) International Agency for Research on Cancer / WHO · 2024
  4. NCCN Guidelines for Patients: Head and Neck Cancers National Comprehensive Cancer Network · 2025
  5. Head and Neck Cancers (patient information) US National Cancer Institute · 2025
  6. About Head and Neck Cancer American Cancer Society · 2025

Written and medically reviewed by Xiangpeng Liu, MD

Associate Chief Physician, ENT & Head/Neck Surgery · Chenzhou First People’s Hospital, Chenzhou, Hunan, China

Editorial policy & reviewer credentials · All sources

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Medical disclaimer: This knowledge base is general information for people researching head and neck tumours, not a diagnosis or treatment plan. It does not replace an examination by a qualified physician. Survival figures are population averages, not predictions for an individual. Treatment and cost estimates for China are illustrative only and must be confirmed in writing after your records have been reviewed. If you have a symptom lasting more than two to three weeks, see a doctor promptly.