Bouhafs Khalid, Lachkar Azeddine, Bouamama Tayeb, Miry Achraf, Benfadil Drissia, Ghailan Mohammed Rachid
Otorhinolaryngology and Head and Neck Surgery Department, Mohammed VI University Hospital of Oujda, Oujda, Morocco.
Radiology Department, Mohammed VI University Hospital Center of Oujda, Oujda, Morocco.
J Surg Case Rep. 2022 Jun 22;2022(6):rjac286. doi: 10.1093/jscr/rjac286. eCollection 2022 Jun.
Chondrosarcoma is a highly aggressive malignant tumor originating from cartilaginous and mesenchymal tissues. The aim of this report is to describe a rare case of nasosinusal chondrosarcoma with orbito-cerebral extension. Our patient was a 55-year-old with a right cheek swelling evolving over a year, with unilateral right nasal obstruction gradually becoming bilateral associated with hyposmia, bilateral exophthalmos, reduced bilateral deep visual acuity and permanent headaches. The clinical examination found a tumor obstructing the two nasal cavities. Imaging showed a lobulated heterogeneous tissue process occupying the paranasal sinuses, with calcifications and enhancement at its periphery, extending to the orbito-cerebral area. The histopathological analysis was in favor of chondrosarcoma. The patient was first treated with an incomplete surgical resection by an endonasal route due to the extension to the orbit and the brain and received adjuvant radiotherapy. Surgical excision is a prognostic factor in this type of sarcomas and reduces recurrence rates.
软骨肉瘤是一种起源于软骨和间充质组织的高度侵袭性恶性肿瘤。本报告旨在描述一例罕见的鼻窦软骨肉瘤伴眶脑侵犯病例。我们的患者是一名55岁男性,右侧脸颊肿胀持续一年,单侧右鼻塞逐渐发展为双侧,伴有嗅觉减退、双侧眼球突出、双侧深部视力下降和持续性头痛。临床检查发现肿瘤阻塞双侧鼻腔。影像学检查显示一个分叶状的不均匀组织病变占据鼻窦,周边有钙化及强化,延伸至眶脑区域。组织病理学分析支持软骨肉瘤诊断。由于肿瘤侵犯眼眶和脑部,患者首先接受了经鼻内镜的不完全手术切除,并接受了辅助放疗。手术切除是这类肉瘤的一个预后因素,可降低复发率。