Abstract
INTRODUCTION AND IMPORTANCE: Chondrosarcoma is a primary malignancy affecting mainly long bones. The location in the sinonasal tract and in a young female patient is exceptional. We aim through this case report to relate our own experience with a combined endoscopy-navigation approach in the resection of an ethmoidal chondrosarcoma. CASE PRESENTATION: We report the case of an 18-year-old girl, who was presenting hyposmia, headache and unilateral retroorbital pain with a normal physical exam. Imageries were performed showing an invasive tissular and calcified ethmoidal tumor recalling a chondrosarcoma. She underwent a macroscopic complete resection of the tumor via a binostril endoscopic endonasal approach using navigation. Postoperative head CT and MRI showed a complete resection of the tumor. CLINICAL DISCUSSION: The gold standard treatment is a complete surgical excision with tumor-free margins which is challenging in the ethmoidal location. In literature, the role of navigation in endoscopic surgeries is debated. In our case, the navigation-guided binostril endoscopic approach enabled a precise tumor localization, with a wide field of vision of vital structures nearby and of tumor limits, ensuring an excellent result with an optimal resection. CONCLUSION: Chondrosarcomas of the sinonasal tract are rare and represent a compelling diagnostic and treatment challenge. Surgery is the mainstay treatment of sinonasal chondrosarcomas. Endoscopic endonasal surgery associated with surgical navigation offers a great control of the lesion and its margins with good results motivating its adoption as a therapeutic strategy in selected cases.