• Most strongly associated with cigarette smoking

• Human papillomavirus genome has been detected in some neoplasms

• Nickle ore exposure

• • whether same mechanism of BPDE (catabolite of benzo[a]pyrene in cigarette smoke) binds p53 mutational hot spots as in lung carcinoma

• p53 mutation affects cell replication and centromere replication

• Usually men with long cigarette smoking history

• Age generally >50 years

• Present with pain in sinus

• All neoplasms spread to the regional lymph nodes

• Eventually spread to lungs and other distant sites

• Extensive morbidity and mortality due to local disease with airway obstruction, hemorrhage, infection

• Treatment modalities include surgery and radiation

• Death usually due to local spread

Visit National Cancer Institute for Current Treatment

• Granular, gray white, exophytic or ulcerated neoplasm

• May erode bone or occasionally infiltrate it to result in pathologic fracture

• Hyperchromatic nuclei with irregular outlines

• Prominent nucleoli

• Can range from well to poorly differentiated

• May be keratinizing with pearl formation

• Sternberg SS ed. Diagnostic Surgical Pathology, 2d edition, Lippincott-Raven; Philadelphia. 1996, pp. 861-2.

• Current literature from PubMed at National Library of Medicine