Chondrosarcoma of Nasal Cavity: a Rare Entity
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CASE REPORT
Chondrosarcoma of Nasal Cavity: a Rare Entity Pankaj Kumar Sahu 1 & Lovraj Goyal 1
&
Jitendra Bothra 1 & Shashivadhanan 1 & Pragya Sharma 1
Received: 21 June 2020 / Accepted: 19 August 2020 # Indian Association of Surgical Oncology 2020
Abstract Chondrosarcoma of nasal cavity is a rare entity, and only few case reports exist. Diagnosis is made on histopathological analysis. Differentiating chondrosarcoma from chondromas can be challenging. Surgical excision remains the treatment of choice. We report a case of a 73-year-old male who presented to us with complaints of bilateral nasal obstruction. Histopathology reported as moderately differentiating chondrosarcoma. Patient subsequently underwent excision of tumor by craniofacial resection with adjuvant radiotherapy. Patient is on regular follow-up and has shown no evidence of recurrence. Keywords Chondrosarcoma . Craniofacial resection . Nasal septum
Introduction Chondrosarcoma are malignant mesenchymal cartilage forming tumor that accounts for 8% of all head and neck sarcomas and only 0.1% of all head and neck malignancies [1]. Three to twelve percent of all chondrosarcomas occur in the head and neck region [2, 3]. Although the histological appearances of this tumor are characteristics, a differential diagnosis of chondroma, chordoma, and chondromyxoid fibroma should be considered [4]. Chondrosarcoma with tendency for multiple recurrences and progressive spread is considered to have poor prognosis [5]. Chondrosarcoma of nasal cavity is a rare entity, and approximately 63 cases of chondrosarcoma originating from the nasal septum have been reported in review of literature from 1927 to 2017 [6]. Hereby, we are reporting a case of chondrosarcoma of nasal cavity with extension up to skull base and involvement of paranasal sinuses.
Case Report A 73-year-old male reported with complaints of gradually progressive bilateral nasal obstruction of 2 years duration * Lovraj Goyal [email protected] 1
Department of ENT and Head and Neck Surgery, Command Hospital Air Force, Bangalore, India
which was more on the left side as compared with the right. Patient also had complaints of anosmia. There were no complaints of nasal discharge, epistaxis, headache, facial pain, paresthesia over cheeks, diminished vision, cranial nerve defects, and fever. On clinical examination, there was broadening of the nasal bridge (Fig 1). Patient had proptosis on left side with no restriction of eye movement. Anterior rhinoscopy revealed firm to hard mass in bilateral nasal cavity beyond which there was no visualization due to the mass blocking nasal cavity on both the sides. On probe test, mass was nontender, not bleeding on touch, and probe could not be passed lateral to the mass on both nasal cavity. Oral cavity examination revealed a bony bulge on the midline of hard palate extending to the right side ( Fig 2). Nasal endoscope could not be maneuvered beyond the growth on both the sides. A CT scan of nasal cavity and PNS (Figs 3, 4) showed a hyperdense lesion completely filling
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