Sinonasal Chondrosarcoma Four Cases And Literature Review

ObjectiveTo analyze the clinical characteristics,imaging and pathological characteristics,treatment and prognosis of sinonasal chondrosarcoma,in order to improve the understanding and treatment of the disease.Materials and MethodsThe clinical data of 4 cases of sinonasal chondrosarcoma which were treated from May 2012 to Dec.2016 in the second Hospital of the Jilin University were retrospectively studied.Make a summary of the clinical features,characteristics of imaging and pathology,treatment and prognosis.ResultsThere were 1 male and 3 females in this study.Age ranged from 37 yeas old to 61 yeas old and the mean age was 49 yeas old.The course of the disease ranged from 1 month to half a year.One occurred in the frontal sinus;one occurred in the maxillary sinus,involving the temporal fossa,hard palate,nasal cavity;two occurred in the sphenoid sinus,one case of skull base was infringed.One complainted nasal obstruction with headache;one simply presented with headache;one had toothache,cheekand hard palate swelling;one had headache with decreased vision.With electronic nasopharyngoscope,the tomor was seen as pink or gray mass with the surface bulging.CT showed soft tissue density shadow,and can clearly show the destruction of bone and calcification within the tumor.On MRI,sinonasal CS was seen hypointense or isointense on T1-weighted and hyperintense on T2-weighted images and the intension was uneven.With contrast,the lesions showed mild to moderate enhancement,with the surrounding tissue invasion situation.3 cases were diagnosed and classified according to histomorphology while one was diagnosed with immunohistochemical.3 cases were treated with endoscopic surgeries,1 with maxillectomy.1 had a recurrence after 2months,and died due to invasion of intracranial and orbital after more than 1 year.2 had no recurrence after 7months and 1 had no recurrence after 3months.Conclusions1.Sinonasal chondrosarcoma is a slow growing tumor that rarely metastasizes but has a high rate of local recurrence.2.CT and MRI can provide reliable preoperative evaluations for sinonasal CS.3.The diagnosis relies on postoperative examination of large or complete tumors.Vimentin and S-100 protein immunohistochemical staining positive are the pathological characteristics of the tumor,which isdistinguished from other tumors.4.A radical resection on the treatment of choice for the disease,radiation therapy is mainly used for high-level,unresectable or local palliative resection of the tumor.