Sinonasal tract chondrosarcoma: 18-Year experience at a single institution
Introduction
Chondrosarcomas are quite uncommon malignancies which may originate from bones or soft tissues. They can occur anywhere in the body, but the most common sites are pelvis, long bones and ribs [1]. The head and neck chondrosarcomas are much rarer, accounting for only 1–12% [2], [3]. They grow slowly, but they are locally aggressive and easy to relapse. About 50% of the head and neck chondrosarcomas arise from sinonasal tract [4]. Due to anatomical characteristics, chondrosarcomas in the sinonasal tract usually invade the vital structures, which lead to a poor prognosis if treated insufficiently.
To date, only a few series have been reported, many controversies are still persistent concerning the appropriate treatment modality. In the current study with a relatively large group, we reviewed the clinical features, diagnosis, treatments and outcomes of 24 patients with sinonasal tract chondrosarcomas treated in our institution from 1994 to 2011. Moreover, our study focused on the validity and advantage of endoscopic technique compared with conventional surgery.
Section snippets
Materials and methods
A retrospective study reviewed 24 patients diagnosed as sinonasal tract chondrosarcoma at the Eye, Ear, Nose and Throat Hospital of Fudan University between 1994 and 2011. This study was approved by the institutional review board of Fudan University. All the surgical specimens were proven by histological examination. Clinical information including gender, age, medical history, symptoms, radiographic findings, tumor site and grade, treatment, recurrence and outcome were recorded. Follow-up until
Patient demographics and clinical findings
There were 10 males and 14 females in the series. The ages at diagnosis ranged from 7 months to 67 years (mean age, 34.9 years; median age, 35.5 years). The most common sites were maxillary sinus (12 cases, 50.0%) and sphenoid sinus (11 cases, 45.8%). The chief complaints were nasal obstruction (11 cases, 45.8%) and swelling/mass (8 cases, 33.3%). Pain and visual impairment were other frequent symptoms. Symptoms can be present for up to 24 months with an average of 7.6 months before diagnosis.
Discussion
The etiology of chondrosarcomas remains uncertain. Various factors including irradiation, previous surgery and accidental trauma may associate with chondrosarcomas. In addition, some benign bony conditions such as chondromyxoid fibroma, fibrous dysplasia, multiple hereditary exostosis can be the risk factors [1], [5]. So a longer follow-up period is necessary for these tumors. Particularly, malignancy must be suspected when previous symptoms and signs become worse in a short time. In the
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Theses authors contributed equally to this work.