Introduction: Fibrosarcoma is a malignant neoplasm, with nasal localization uncommon. Clinically, the main symptoms are epistaxis and nasal obstruction. Microscopically, it is characterized by a dense proliferation of fibroblasts with a herringbone pattern and spindle-shaped cells with hyperchromatic nuclei.
Presentation of case: We report a nasal fibrosarcoma of a 37-year-old woman with a recurrent history of epistaxis and nasal obstruction for several years. A biopsy was performed, and the histopathological findings reported a dense proliferation of fibroblasts with a herringbone pattern and spindle-shaped cells with hyperchromatic nuclei. The immunohistochemistry was positive for Ki67, P53, and vimentin staining. The final diagnosis was nasal fibrosarcoma. The patient underwent functional endoscopic sinus surgery and extirpation of the tumor on the wall of the right maxilla, right ethmoid sinus, and right frontal area. Thirteen months later, the patient experienced a recurrence. An external approach was taken under general anesthesia via lateral rhinotomy with medial maxillectomy. The patient underwent chemotherapy with a regimen of paclitaxel and cisplatin for six cycles.
Discussion: We gave chemotherapy in this case because the patient experienced a recurrence, tumor-free margins were not obtained, and a computed tomography scan showed bone involvement.
Conclusion: Nasal fibrosarcoma is a rare malignant neoplasm, which can be diagnosed by its histopathological features and immunohistochemistry.
Keywords: Case report; Epistaxis; Fibrosarcoma; Immunohistochemistry; Nasal cavity; Nasal obstruction.
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