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Health condition

Nose and sinus tumours, the sinusitis that isn't sinusitis.

Rare cancers of the nose and sinuses often masquerade as ordinary sinusitis. Knowing when one-sided symptoms deserve a closer look can shorten the road to diagnosis. For the full clinical picture, including staging, see our companion guide to nasal and paranasal sinus tumours.

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Why trust this guide

  • 01

    Editorial team

    Written by our editorial team from the UK sources listed on each page.

  • 02

    Sourced from guidance

    Checked against NICE NG12 and specialist head and neck oncology sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK guidance on urgent referral, MDT staging and specialist commissioned treatment.

Key facts

Nose and sinus tumours at a glance.

The essentials, in plain English - what these tumours are, who is at risk, and how they are managed in the UK today. See also our detailed nasal and paranasal sinus tumours guide for staging and MDT pathway detail.

  • What it is

    Rare cancers of the nose and sinuses - arising in the nasal cavity or one of the paranasal sinuses, most often the maxillary sinus.

  • Most common type

    Squamous cell carcinoma accounts for the majority of cases, though other histologies are seen.

  • Occupational link

    Strongly linked to wood dust, nickel and leather work exposures - often accumulated over many years in a trade.

  • Why it is missed

    The symptoms overlap so closely with ordinary sinusitis that diagnosis is frequently delayed.

  • Who assesses it

    Specialist commissioned ENT and head and neck oncology multidisciplinary teams.

  • Core treatment

    Surgery and radiotherapy, often combined, given how close these sinuses sit to the orbit and skull base.

Why this guide matters

When "just sinusitis" needs a second look.

These tumours are rare, but the symptom overlap with ordinary sinusitis is exactly what delays diagnosis. Three points shape everything else on this page.

  • One-sided symptoms are the clue

    Genuine sinusitis is usually bilateral. Persistent blockage, discharge or bleeding on one side is what should prompt reassessment.

  • Occupational history matters

    Wood dust, nickel and leather work exposures raise suspicion and are worth mentioning explicitly to your GP.

  • Specialist MDT care changes outcomes

    Because these cancers sit next to the orbit and skull base, treatment planning in a specialist head and neck oncology MDT is essential.

How the diagnosis is made

From persistent symptoms to a specialist plan.

The steps a UK GP and specialist team will normally follow, in order, per NICE NG12 - so you know what to expect and why.

  1. 01

    Assessing

    Persistent one-sided symptoms

    Nasal blockage or discharge on one side only, that has not settled with standard sinusitis treatment, prompts a closer look.

  2. 02

    Assessing

    Urgent referral criteria

    NICE NG12 recommends urgent referral where unilateral nasal symptoms persist beyond the expected course of sinusitis treatment.

  3. 03

    Assessing

    Nasendoscopy

    A thin flexible camera examines the nasal cavity directly, looking for a mass, ulceration or an unusual bleeding point.

  4. 04

    Confirming

    CT imaging

    Cross-sectional imaging maps the extent of any lesion and its relationship to the sinuses, orbit and skull base.

  5. 05

    Confirming

    MRI for soft tissue and staging

    MRI adds detail on soft-tissue and perineural spread that CT can miss, and supports formal staging.

  6. 06

    Confirming

    Biopsy for histology

    Tissue sampling confirms the diagnosis and the histological subtype, which shapes the treatment plan.

  7. 07

    Planning

    Head and neck oncology MDT

    A specialist commissioned multidisciplinary team agrees the surgical, radiotherapy and chemotherapy plan together.

Typical timeline: urgent referral to a specialist MDT decision, usually within a few weeks.

Symptoms

What nose and sinus tumours actually look like.

A cluster of one-sided symptoms that persist beyond ordinary sinusitis. And the features that mean it's time to escalate.

  • Blocked nose on one side

    Persistent blockage affecting only one nostril - the single most characteristic early symptom, and easy to mistake for simple congestion.

  • One-sided nasal discharge

    Discharge from one nostril, sometimes blood-stained, that does not respond to usual sinusitis treatment.

  • Nosebleeds

    Recurrent or unexplained bleeding from one nostril deserves a closer look, especially alongside other symptoms.

  • Facial pain or swelling

    Pain or a visible swelling over the cheek or around the sinuses, sometimes with tenderness.

  • Loosening of upper teeth

    A tumour extending from the maxillary sinus can loosen the upper molars or premolars - an easily overlooked clue.

  • Double vision or visual change

    Double vision or other visual disturbance suggests involvement of the orbit and needs prompt specialist assessment.

  • Facial numbness

    Altered sensation over the cheek or upper lip can reflect nerve involvement as disease advances.

  • Red flag - "sinusitis" that will not settle

    When sinus symptoms fail to clear despite proper treatment, this is exactly the pattern that leads to delayed diagnosis.

Treatment

How nose and sinus tumours are treated in the UK.

Surgery and radiotherapy form the backbone of treatment, with chemotherapy, reconstruction and rehabilitation supporting the wider plan.

  • Surgical resection

    Often complex given proximity to the orbit and skull base - may require craniofacial resection performed jointly by ENT and neurosurgery.

  • Radiotherapy

    Frequently combined with surgery, either before or after, to improve local control given the challenging anatomy involved.

  • Chemotherapy

    Used for advanced or metastatic disease, sometimes alongside radiotherapy as a combined chemoradiotherapy approach.

  • Craniofacial resection

    A joint ENT and neurosurgical procedure when the tumour approaches or involves the skull base.

  • Reconstructive surgery

    Reconstructs the nasal, sinus or facial structures removed during resection, sometimes with the help of prosthetics.

  • Facial prosthetics

    Where reconstruction alone cannot restore appearance or function, a maxillofacial prosthetist can fit a bespoke prosthesis.

  • Speech and language therapy

    Supports speech, swallowing and voice where surgery or radiotherapy affects these functions.

  • Dietetic support

    Helps maintain nutrition through treatment, particularly where eating or swallowing is affected.

For a fuller breakdown of staging and how the MDT sequences surgery, radiotherapy and chemotherapy, read our nasal and paranasal sinus tumours guide.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or ENT specialist knows your history and can tell you which parts apply to you. If in doubt, get seen.

  • NICE. Suspected cancer: recognition and referral (NG12).

  • National Cancer Institute. Paranasal sinus and nasal cavity cancer treatment.

  • British Association of Head and Neck Oncologists. Standards for head and neck cancer care.

  • Public Health England. Occupational cancer - nasal and sinus cancer risk factors.

Red flags

When nose or sinus symptoms need urgent attention.

Most nasal symptoms are ordinary sinusitis or allergy. These are the situations that aren't - and where urgent referral is needed.

  • Persistent one-sided nasal blockage

    Blockage on one side only that does not resolve after appropriate treatment is the classic warning sign and warrants urgent referral.

  • One-sided blood-stained discharge

    Blood-stained or persistent one-sided discharge is not typical of simple sinusitis and needs specialist assessment.

  • Double vision or visual disturbance

    Double vision or other visual change points to possible orbital involvement and needs urgent specialist review.

  • Loosening of upper teeth

    Unexplained loosening of the upper teeth, without dental disease to explain it, can signal maxillary sinus involvement.

  • Non-healing facial swelling

    A firm, non-tender or enlarging facial swelling that does not settle deserves imaging rather than watchful waiting.

  • Occupational exposure history

    Long-term exposure to wood dust, nickel or leather work raises the index of suspicion for any of the above symptoms.

  • Symptoms outlasting sinusitis treatment

    Any "sinusitis" that fails to improve on standard treatment should prompt reassessment rather than a repeat course.

  • Cranial nerve symptoms

    Facial numbness, weakness or other cranial nerve signs suggest possible skull base or perineural spread.

  • Unexplained weight loss with nasal symptoms

    Systemic features alongside persistent nasal symptoms should always be flagged for urgent specialist assessment.

Living with it

A rare cancer, with a specialist team behind you.

Four things that make the biggest difference through treatment and beyond - specialist care, planned rehabilitation, restored function and long-term follow-up.

A quiet reminder

You are not managing this alone.

A dedicated head and neck oncology MDT, speech and language therapists and dietitians work alongside you from diagnosis through recovery.

  1. 01 Team

    You are cared for by a specialist team

    Treatment happens in a specialist commissioned head and neck cancer centre with a dedicated multidisciplinary team around you.

  2. 02 Recovery

    Rehabilitation is part of the plan

    Speech and language therapy and dietetic support help you recover function, not just treat the tumour.

  3. 03 Function

    Appearance and function can be restored

    Reconstructive surgery and, where needed, facial prosthetics aim to restore how you look and how you breathe, eat and speak.

  4. 04 Follow-up

    Long-term follow-up matters

    Regular specialist review after treatment helps catch recurrence early and manage any lasting effects.

Frequently asked

Everything we get asked about nose and sinus tumours.

Quick answers on symptoms, referral criteria, diagnosis and treatment.

  • What are nose and sinus tumours?

    Rare cancers of the nasal cavity or the paranasal sinuses, with the maxillary sinus being the most commonly affected site. Squamous cell carcinoma is the most common type. They are strongly associated with occupational exposures such as wood dust, nickel and leather work. Clinicians often refer to this same condition as nasal and paranasal sinus tumours.

  • Why are nose and sinus tumours often diagnosed late?

    Early symptoms - a blocked nose on one side, discharge or facial pain - closely mimic ordinary sinusitis. This overlap frequently leads to diagnostic delay, which is why NICE NG12 sets a low threshold for urgent referral when one-sided symptoms persist.

  • When does NICE recommend urgent referral for nasal symptoms?

    NICE NG12 recommends urgent referral for unexplained one-sided nasal symptoms that persist beyond the expected course of sinusitis treatment, particularly with bleeding, facial pain, visual change or loosening of the upper teeth.

  • How is a nose or sinus tumour diagnosed?

    Nasendoscopy allows direct examination of the nasal cavity, followed by CT and MRI imaging to assess the extent of disease and biopsy to confirm the histological diagnosis. A specialist commissioned ENT and head and neck oncology MDT then agrees the treatment plan.

  • What does treatment for a sinus tumour involve?

    Surgery is often complex because of the proximity to the orbit and skull base, and may require craniofacial resection. Radiotherapy is frequently combined with surgery, and chemotherapy is used for more advanced disease. Reconstructive surgery, prosthetics and MDT rehabilitation support recovery afterwards.

  • Is this the same condition as nasal and paranasal sinus tumours?

    Yes. "Nose and sinus tumours" and "nasal and paranasal sinus tumours" describe the same group of cancers - our companion guide covers the full clinical detail, including staging and NICE NG12 referral criteria in depth.

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