General Medical Information

Malignant Tumors Of Bony Origin

Barbara A. Zeifer

The most common malignant bone tumors of the paranasal sinuses are multiple myeloma, osteogenic sarcoma, and chondrosarcoma. Ewing sarcoma and malignant fibrous histiocytoma are rare. Plasma cell dyscrasia is most commonly associated with the generalized bone disease of multiple myeloma. Solitary plasmacytoma of bone or extraosseous plasmacytoma also can occur. Involvement of the paranasal sinuses is seen as a soft-tissue mass that is expansile and well defined but locally destructive. These tumors are associated with multiple lytic skeletal lesions in 85% of cases. Seven percent of osteogenic sarcomas are said to occur in the jaw. These aggressive lesions often are purely lytic but can be associated with either amorphous calcification or a sunburst appearance of radiating periosteal new bone. Without new bone formation, the specific diagnosis of osteosarcoma is not suggested. Chondrosarcoma of the paranasal sinuses is rare. Chondrosarcoma is a soft-tissue mass that usually contains amorphous, “popcorn” calcifications. The well-differentiated lesions can have a benign radiographic appearance; more aggressive lesions are more destructive. These tumors are not associated with the periosteal reaction that occurs with osteosarcoma.