Association between Sinonasal Adenocarcinoma and Dental Clinical Manifestations

Background: Paranasal adenocarcinoma (PAC) is a relatively rare malignant disease of the sinonasal tract that frequently manifests as nonspecific dental and maxillofacial symptoms, contributing to a delayed diagnosis and late-stage detection. Objectives: The study aimed at evaluating the correlation of paranasal adenocarcinoma with different dental clinical parameters and the predictive relationship between these parameters as well as with tumor grading based on histopathologic evaluation. Methods: A case–control study was performed at the Warith International Cancer Institute for a period of time from April 2024 to February 2025. This study involved a sum of 35 patients with paranasal adenocarcinoma diagnosed by histopathological methods and 50 healthy subjects matched for age and sex as control group. The diagnosis and grading of tumor (Grade I-III) was verified by histopathological methods. Dental signs and symptoms such as tooth mobility without periodontal disease, unremitting pain in the maxillary area, gingival swelling in a proximity of an upper molar and non-healing extraction sockets were thoroughly examined. Results: Dental clinical patients were significantly more often observed among PAC subjects than controls: tooth mobility (51.4% vs 4%) chronic maxillary pain (60% vs 6%), swelling near upper molars (45.7% vs 2%) non-healing extraction sockets (28.6%, no cases in the control group) with p<0.001. A multiple regression analysis demonstrated that persistent maxillary pain and tooth loss was a significant independent variable for greater tumor grade (β = 0.41, p = 0.004; β = 0.36, p = 0.009). Conclusion: Specific dental symptoms, especially persistent maxillary pain and unexplained tooth mobility, are highly associated with paranasal adenocarcinoma, and might be early clinical markers of advanced stages of disease development.