Adenocarcinoma of the Ethmoid Sinus: An Occupational Disease

Introduction: Intestinal-type adenocarcinoma of the ethmoid is the most frequent histotype in Europe. The association between this tumor and the exposure to wood or leather dust has been well documented.

Material and Methods: We investigated exposure to wood or leather dust in 499 patients with sinonasal tumors treated at the National Cancer Institute of Milan. The original tumor site and histology were carefully assessed.

Results: Ethmoidal tumors were 249 cases; 124 were adenocarcinomas; 90.4% had previously been exposed to wood or leather dust (16.3% for only a short time and long before the onset of the disease). Only 2 of the remaining patients with ethmoidal tumors other than adenocarcinomas had ever been exposed to these dusts. Nonethmoidal sinonasal tumors were 250 cases; 17 of these (6.8%) were adenocarcinomas; no exposure to wood or leather dust was reported in any of these patients.

Conclusions: The ethmoid is the sinonasal site involved by adenocarcinoma induced by wood or leather dust. Even a short and remote exposure seems to be sufficient to increase the incidence of this tumor. No significant correlation was observed between exposure and either nonethmoidal sinonasal tumors or ethmoidal tumors other than adenocarcinomas. In light of the above results, all available technology should be employed to remove wood and leather dust from workplaces. Otorhinolaryngologists must verify whether a patient with nasal obstruction and/or nosebleed has ever been exposed to any oncogenic agent in the past.