Fibrosarcoma arising in the paranasal sinus: a clinicopathological and radiological analysis.

OBJECTIVES: To analyze the clinicopathological features and the CT and MRI features of patients with paranasal sinus fibrosarcoma.

METHODS: Seven patients with surgically and pathologically confirmed paranasal sinus fibrosarcoma were enrolled. Their CT and MRI data and imaging features were retrospectively analyzed in detail.

RESULTS: The study participants were two males and five females (median age, 43 years; range, 22-73 years). CT or MRI showed a well-defined (n = 5) or ill-defined (n = 2), irregular (n = 6) or oval (n = 1) mass, with heterogeneous (n = 7) density. The lesions were isointense (n = 4) or hypointense (n = 2) on T1  weighted images, and showed heterogeneous (n = 6) mild hypointensity on T2  weighted images. Expansive (n = 6) and osteolytic (n = 1) bone destruction were observed. The tumors showed marked heterogeneous delayed enhancement (n = 6) on contrast-enhanced MRI images.

CONCLUSION: Paranasal sinus fibrosarcomas should be included in the differential diagnosis when a sinonasal neoplasm appears as a well- or ill-defined unilateral large irregular mass with characteristic mild hypointensity on T2  weighted MR images and shows expansive or osteolytic bone destruction and a marked heterogeneous delayed contrast-enhancement pattern.