Chondrosarcoma of the nasal septum

Abstract

Chondrosarcoma of the nasal septum is a rare malignancy. When it occurs, early diagnosis is difficult because patients generally present with common, non-specific sinonasal complaints. This is the report of a 62-year-old woman who presented with a 1-month history of nasal obstruction, headache and anosmia. Nasal endoscopy showed a nasal mass obstructing both nasal cavities not separable from the septum. A wedge biopsy of the nasal mass was taken. Histopathology was suggestive of chondrosarcoma. The tumour was removed by an endoscopic approach. The clinical presentation, diagnosis and treatment of this case as well as a review of the literature are discussed.

Open resection and reconstruction of a Nasoseptal Chondrosarcoma: Case report and literature review

“…The most frequently reported presenting symptom is nasal obstruction, but patients may also present with a variety of other sinonasal symptoms, such as nasal fullness and chronic discharge, chronic sinusitis, epistaxis, anosmia, facial asymmetry and pain, headaches, and lacrimation. When adjacent structures become involved, conjunctival hyperemia, restricted extraocular movement, diplopia, and exophthalmos may occur [7,[15][16][17]. Nasoseptal chondrosarcomas in particular often present with symmetrical growth into the nasal cavities with subsequent bilateral symptoms.…”

“…With recent advancements of endoscopic endonasal surgery, tumors restricted to the nasal cavity have been shown to be amenable to endoscopic excision with clear margins [7,17,[20][21][22][23][24]. In select cases of nasoseptal chondrosarcomas, the endoscopic approach has yielded favourable oncological and functional outcomes.…”

Condrosarcoma del septum nasal: Reporte de un caso y revisión de la literatura

“…En T1 se describe un patrón aro-arco que corresponde a paquetes fibrovasculares que rodean los nódulos cartilaginosos 14 . La RM resulta fundamental para evaluar la extensión intraorbitaria o intracraneal 15 . El diagnóstico definitivo se realiza mediante la biopsia y el estudio histológico.…”

“…El enfrentamiento quirúrgico depende de la localización del tumor, se han descrito diversas vías de abordaje como el Weber-Ferguson, rinotomía lateral, abordaje sublabialtransnasal, escisión transnasal 15 . Dentro de las nuevas alternativas quirúrgicas asoma la cirugía endoscópica ampliada para la extracción de tumores orbitarios y nasosinusales.…”

“…La recurrencia es la causa más importante de muerte en pacientes con condrosarcoma, no así las metástasis y cuando los márgenes son positivos, la recurrencia a los 5 años es del 65% 6,9 . El seguimiento regular mediante endoscopía nasal es mandatorio para detectar recurrencias a tiempo 15 . Los principales factores pronósticos son la resecabilidad, localización del tumor, el tamaño, el subtipo histológico y el grado.…”