Navigating nasal swelling: the diagnostic journey to osteoblastic osteosarcoma

Authors

  • Tiong Siew Lee Department of Otorhinolaryngology, Hospital Ampang, Selangor, Malaysia
  • Siti Nor’ain Binti Roslim Department of Otorhinolaryngology, Hospital Ampang, Selangor, Malaysia
  • Shahrul Bin Hitam Department of Otorhinolaryngology, Hospital Ampang, Selangor, Malaysia
  • Noorjehan Binti Omar Department of Pathology, Hospital Sultan Idris Shah, Selangor, Malaysia
  • Mohd Zulkiflee Bin Abu Bakar Department of Otorhinolaryngology, University Malaya Medical Center, Kuala Lumpur, Malaysia

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20243517

Keywords:

Nasal swelling, Osteoblastic osteosarcoma, Craniofacial osteosarcoma, Preoperative planning

Abstract

Nasal swelling is frequently encountered in ENT, but diagnosing osteosarcoma in the head and neck region is quite uncommon. Diagnosing and managing craniofacial osteosarcoma is challenging due to its rarity and nonspecific radiological features, which often lead to biopsy errors. Additionally, the proximity to vital structures complicates achieving complete resections. MRI is the gold standard for detailed assessment of osteosarcoma, offering crucial insights into tumor extent, soft tissue involvement, and proximity to surrounding structures for effective treatment planning and response monitoring. CT supports this by aiding in biopsy planning, staging, and detecting metastases, particularly in the chest. Craniofacial osteosarcoma treatment lacks consensus but generally prioritizes surgery, with negative margins crucial for better outcomes. Adjuvant chemotherapy can boost survival, while radiotherapy is used when complete surgery is not possible. In this case, we bring your attention to a 31-year-old gentleman who presented with progressive and painless nasal swelling for 6 months prior to visiting the ORL clinic, where a final diagnosis of osteoblastic osteosarcoma was made after history, examination, imaging, and histopathology results.

Metrics

Metrics Loading ...

References

Ottaviani G, Jaffe N. The epidemiology of osteosarcoma. Cancer Treat Res. 2009;152:3–13.

Krishnamurthy A, Palaniappan R. Osteosarcomas of the head and neck region: a case series with a review of literature. J Maxillofac Oral Surg. 2018;17(1):38.

Prater S, McKeon B. Osteosarcoma. StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books. Accessed on 28 July 2024.

Low CM, Gruszczynski NR, Moore EJ, Price DL, Janus JR, Kasperbauer JL, et al. Sinonasal osteosarcoma: report of 14 new cases and systematic review of the literature. J Neurol Surg B Skull Base. 2021;82(S3):138–47.

Mirabello L, Troisi RJ, Savage SA. Osteosarcoma incidence and survival rates from 1973 to 2004: data from the surveillance, epidemiology, and end results program. Cancer. 2009;115(7):1531.

Bialick S, Campoverde L, Gallegos JAO, Barreto-Coelho P, Watson A, Arora K, et al. Osteogenic sarcoma of the head and neck: is chemotherapy needed? Curr Treat Options Oncol. 2023;24(5):528–41.

Lee’ YY, Van Tassel’ P, Nauert’ C, Raymond AK, Lee YY. Craniofacial osteosarcomas: plain film, ct, and findings in 46 cases. Available at: https://pubmed.ncbi.nlm.nih.gov. Accessed on 21 July 2024.

ElKordy MA, ElBaradie TS, ElSebai HI, Amin AAEW, KhairAlla SM. Osteosarcoma of the jaw: Challenges in the diagnosis and treatment. J Egypt Natl Canc Inst. 2018;30(1):7–11.

Mehta R, Ponnuvelu S, Kuotsu R, Nagarkar NM. Osteosarcoma of the sphenoid sinus extending to ethmoid sinus—report of a rare case with review of literature giving special emphasis on treatment and outcome. Egyptian J Otolaryngol. 2023;39(1):1–8.

10. Kominsky E, Boyke AE, Madani D, Kamat A, Schiff BA, Agarwal V. Biphenotypic Sinonasal Sarcoma: A Case Report and Review of Literature. Ear Nose Throat J. 2023;102(6):385–90.

Plass I, Plass I. Perspective chapter: osteosarcomas of the head and neck. bone tumours-a comprehensive review of selected topics. Available at: https://www.intechopen.com. Accessed on 19 July 2024.

Gopishetty S, Yeh J, Khalid M, Annamaraju P, Guddati AK. Locally Advanced Osteosarcoma of the Ethmoid Sinus: A Report of Successful Management. Case Rep Oncol. 2020;13(2):725–8.

Chatelet F, Simon F, Bedarida V, Clerc N Le, Adle-Biassette H, Manivet P, et al. Surgical Management of Sinonasal Cancers: A Comprehensive Review. Cancers (Basel). 2021;8:13-6.

Chen YM, Gokavarapu S, Shen QC, Liu F, Cao W, Ling YH, et al. Chemotherapy in head and neck osteosarcoma: Adjuvant chemotherapy improves overall survival. Oral Oncol. 2017;73:124–31.

Schwarz R, Bruland O, Cassoni A, Schomberg P, Bielack S. The role of radiotherapy in oseosarcoma. Cancer Treat Res. 2009;152:147–64.

Seidensaal K, Dostal M, Liermann J, Adeberg S, Weykamp F, Schmid MP, et al. Inoperable or incompletely resected craniofacial osteosarcoma treated by particle radiotherapy. Front Oncol. 2022;7:12.

Downloads

Published

2024-11-26