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Updated: May 28, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Malignant ectomesenchymoma of the paranasal sinuses with proptosis
A S Vinck1, B Lerut, R Hermans
1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium.
Problem:
A 36-year-old woman presented with a feeling of pressure in the right orbit and proptosis of the right eye after a "common cold".
Methodology:
Computed tomography (CT) of the maxillofacial region revealed, and endoscopy confirmed, a mass in the right ethmoid sinus, eroding the lamina papyracea and extending into the orbit. Pathology of multiple biopsies revealed a nasal neoplasm composed of neuroectodermal and mesenchymal neoplastic elements, suggestive of a malignant ectomesenchymoma (MEM). Magnetic resonance imaging was used for MEM staging. Computed tomography of the chest and abdomen show no evidence of distant metastases.
Results:
Due to the intracranial and intraorbital extension of the tumour, radical surgery was not an option. Appropriate chemotherapy (6 cycles of vincristine/ifosfamide/adriamycin and 2 cycles of vincristine/ifosfamide/cisplatin) and intensity-modulated radiation therapy were administered.
Conclusion:
Twenty-eight months after treatment, there was no evidence of residual or metastatic disease.
