LOW-GRADE SINONASAL FIBROSARCOMA : A CASE REPORT

Fibrosarcoma is a rare malignant tumor. The sinonasal localization is extremely uncommon.Theclinical presentation is similar to other neoplasms of this region, consisting of nonspecific symptoms such as epistaxis and nasal obstruction. Definitive diagnosis is obtained on the basis of histopathology and immunochemistry.This isthe case of a 40-year-old woman with a six months complaint of left nasal obstruction, recurrent epistaxis, hyposmia and cephalalgia. Nasal endoscopy revealed a regular pink soft-tissue mass filling the left nasal cavity. CT scan and MRI showed a well-defined, irregularly contoured tissue tumor,occupying the left nasal fossa, with matrix of calcifications within the tumor.A biopsy was performed, and the histopathological findings revealed a low-grade fibrosarcoma with spindle-shaped cells arranged in a herringbone pattern. The immunohistochemistry was positive for vimentin staining. The tumor was completely resected with free margins using the endoscopic endonasal approach. No adjuvant radiotherapy was prescribed.The patient is disease-free at a regular five-year postoperative follow-up.Only few cases of sinonasal fibrosarcoma has been reported in literature. There are no specific symptoms or imaging features. Still, this is the first case describing intra-tumoral calcifications. The mainstay of treatment is surgical excision with radical margins.Radiotherapy may be adjunctive in cases of positive margins or incomplete resection.