Malignant tumors of the sinonasal tract in children

Objective: To investigate the clinical manifestations and diagnostic range of malignant masses presenting in the sinonasal tract of pediatric patients and describe the outcomes of endoscopic surgery (EES). Methods: A retrospective cohort analysis was conducted at a special and tertiary university hospital. The study included patients from birth through 18 years of age with a diagnosis of malignant tumors in the sinonasal tract between 2006 and 2019. All the patients underwent endoscopic biopsy or surgery. The survival analysis was performed using Kaplan-Meier estimate and the comparison between groups with the log-rank test. Results: A total of 55 patients were analyzed. Rhabdomyosarcoma, lymphoma, and solitary fibrous tumors were the 3 major diagnoses in these patients. The overall 5-year survival rate was 69.3%. The 5-year survival for each cancer type was 49.7% in rhabdomyosarcoma, 75.0% in lymphoma, and 83.2% in non-rhabdomyosarcoma solid tumors (p=0.018). Patients with a complete surgical resection had a higher 5-year survival rate (82.9%) than patients with an incomplete resection or biopsy (42.5%) (p=0.084). Conclusion: Soft tissue sarcomas are expectedly more common in pediatric patients with sinonasal malignant tumors. EES for malignant sinonasal tumors is a safe and effective treatment for excision of these lesions.