Osteosarcoma of the left maxillary sinus – Case report of an exceedingly rare tumor entity of the paranasal sinuses

Introduction Osteosarcomas as the most common primary malign bone tumors have an incidence of 2-3/ 1.000.000 and mostly affect skeletal bones. The rarer craniofacial osteosarcomas are more challenging to treat because they are usually highly malign, not very responsive to chemotherapy in terms of decreasing in size and more difficult to resect in sano.

Case A 31 years old patient was first presented to us 2021 with a left sided nasal obstruction for 3-4 months, progressive periorbital swelling and CT-graphic signs of a malignant neoplasm of the left maxillary sinus invading the orbit. Histological findings of a highly malign craniofacial osteosarcoma led us to presenting the patient to the Cooperative Osteosarcoma Study group (COSS). They recommended a neoadjuvant chemotherapy analogous to the ERAMOS-1 study and radiation using heavy ions to enable a resection without the need of enucleation. Due to a partial remission a joint surgery with the department for oral and maxillofacial surgery could be performed. The histological results showed a R0 Resektion additionally to a "good response" with a rate of necrosis>90%. The chemotherapy was carried out for two further cycles [1] [2].

Conclusion Therapy of craniofacial osteosarcomas should be carried out in specialized centers and include multidisciplinary treatment to improve the response and event free survival.

Publikationsverlauf

Artikel online veröffentlicht:
19. April 2024

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