Craniofacial resection of a nasoseptal chondrosarcoma: Case report and review of the literature

BACKGROUND Chondrosarcoma of the nasal septum is a rare, malignant neoplasm . A case is presented that illustrates the evaluation and treatment of this malignancy, reviews the relevant literature, discusses surgical approaches , and assesses adjuvant, nonsurgical therapy. METHODS A craniofacial approach using an extended, bifrontal craniotomy and lateral rhinotomy with medial maxillectomy resulted in gross total resecti on at surgery. Because permanent sections of bone margins after decalcifica tion were positive, conformal external beam radiation was used. RESULTS The patient made a complete recovery, returned to work, and is dise ase-free 26 months after treatment, CONCLUSIONS Surgical therapy using an anterior craniofacial resection is th e preferred approach. External beam radiation therapy is potentially indica ted for the following: positive or close surgical margins on permanent hist opathology, extensive tumor with known residual at operation, or local recu rrence not amenable to resection. Because of late local recurrence, lifelon g follow-up is required.