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Malignant tumors of the latticed bone: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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In the overwhelming majority of cases, malignant tumors of the latticed bone belong to undifferentiated epitheliomas and originate from any one part of the latticed labyrinth. These tumors metastasize to distant bones and lungs. Sarcomas in this area are rare. In the first stage of development, the tumor first fills all the cellular space of the trellis, destroying the intercellular septa, then spreads into the nasal cavity, other paranasal sinuses and orbit. In the latent stage, these tumors produce virtually nothing themselves and can not obtain convincing radiographic data that testify to its presence. If we add to this that at this stage it does not manifest any symptoms, it becomes obvious why in the latent period malignant tumors of the latticed bone are almost never recognized. Differing in small size, these tumors are not as radiopaque as, for example, tumors of the upper jaw, so even with the appearance of any clinical signs they are often mistaken for banal etmoiditis, often chronic polyposis etmoiditis, especially when there are "support polyps". Removal of polyps and endonasal opening of the trellis labyrinth with scraping of the anterior cells does not bring improvement; on the contrary, polyps quickly recur and together with them - a tumor tissue.
More abundant bleeding with etmoidotomy in these cases often does not pay attention to itself, because with banal inflammatory processes this surgical intervention often also causes significant bleeding. But the latter's difference from the "cancer" is that with a banal inflammatory process, bleeding after surgery quickly stops, and in a malignant tumor, even after a "radical" scraping of the trellis labyrinth, bleeding persists for a long time and often a posterior tamponade of the nose is required. Another distinctive feature that should alert a surgeon to the presence of a malignant tumor in the trellis labyrinth is that with banal etmoiditis, in which the bulk of the trabecula is retained and when the cells are scraped out a characteristic crunch is heard, in a malignant tumor, the spoon freely penetrates into the tumor-affected cavity, filled with an easily collapsing mass.
[Symptoms of malignant tumors of the lattice
If the tumor reaches significant dimensions and extends beyond the latticed labyrinth, then there are pronounced subjective and objective symptoms of malignant tumors of the latticed bone, manifested by the syndrome of malignant damage to the nasal cavity and surrounding tissues. At this stage, radiographic signs of tumor lesion of the trellis are revealed, which consist in intensive unilateral shading of the rhinoemoidal area and violation of the integrity of the bone walls of adjacent sinuses and orbit.
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Treatment of malignant tumors of the trellis
Treatment of malignant tumors of the trellis is combined, as with suprastructural tumors of the maxillary sinus, and basically only palliative.
What is the prognosis of malignant tumors of the lattice?
Malignant tumors of the latticed bone due to late recognition of the tumor, as a rule, have an unfavorable prognosis, especially with the destruction of the trellis plate and the penetration of the tumor into the anterior cranial fossa, and when penetrating the retrobulbar region into the middle cranial fossa.