Nasosinusal chondrosarcoma with orbito-cerebral extension

Area of Science:

• Oncology
• Otorhinolaryngology
• Neurosurgery

Background:

• Chondrosarcoma is a rare, aggressive malignant tumor arising from cartilaginous and mesenchymal tissues.
• Nasosinusal chondrosarcomas are exceptionally rare, often presenting with complex extensions.

Observation:

• A 55-year-old patient presented with a year-long history of cheek swelling, progressing nasal obstruction, hyposmia, bilateral exophthalmos, decreased visual acuity, and headaches.
• Clinical examination revealed a tumor obstructing both nasal cavities.
• Imaging demonstrated a lobulated, heterogeneous mass in the paranasal sinuses with calcifications and peripheral enhancement, extending into the orbito-cerebral region.

Findings:

• Histopathological analysis confirmed chondrosarcoma.
• The tumor exhibited significant extension to the orbit and brain.
• Initial treatment involved incomplete surgical resection via an endonasal approach followed by adjuvant radiotherapy.

Implications:

• This case highlights the diagnostic and therapeutic challenges of advanced nasosinusal chondrosarcoma.
• Complete surgical excision is a critical prognostic factor for improving outcomes and minimizing recurrence in chondrosarcoma patients.
• Multidisciplinary management is essential for addressing the complex anatomical involvement in such rare tumors.