Sinonasal tract chondrosarcoma: 18-year experience at a single institution.

OBJECTIVE

Sinonasal tract chondrosarcomas are considered rare malignancies. Few large series evaluated the clinicopathological characteristics of these tumors. The aim of this study was to describe clinical findings, management and outcome of 24 cases of sinonasal tract chondrosarcoma from a single institution and to focus on the validity and advantage of endoscopic technique compared with conventional surgery.

METHODS

A retrospective analysis of clinical information was performed on 24 patients diagnosed as the sinonasal tract chondrosarcomas between 1994 and 2011.

RESULTS

There were 10 males and 14 females (age range, from 7 months to 67 years; mean age, 34.9 years) in this study. The main complaints were nasal obstruction and swelling/mass. The most common affected sites were maxillary sinus and sphenoid sinus. Except one case of myxoid chondrosarcoma and two cases of mesenchymal chondrosarcoma, 17 patients (70.8%) and 4 patients (16.7%) were, respectively, grade I and II. Three patients were misclassified as other tumors at other hospitals. Two cases had a history of radiation. Five cases superimposed upon a preexisting benign bony conditions. Twenty-three of 24 patients were treated with wide surgical excision, including 15 patients with conventional surgeries by external approach and 8 patients with endoscopic surgeries. Local recurrence was observed in 12 patients. The mean interval of recurrence with endoscopic surgery (37.8 months) was longer than conventional approach (21.9 months), but it did not achieve statistical significance due to small sample size. The 5-year disease-specific survival rate was 83.3%.

CONCLUSION

Chondrosarcomas of the sinonasal tract are rare. The patients with earlier diagnosis and adequate surgical treatment have a more favorable prognosis. Uncontrollable local disease resulting in compression of adjacent critical structures is the most common cause of death.