Clinical and Endoscopic Findings
Sarcomas of the sinonasal tract, especially low-grade lesions, may silently grow for a long period of time. Symptoms may be present for as long as 46 months before the lesion is diagnosed (Patel et al. 2002a); they are frequently related to the extension into the surrounding spaces, which causes eye ball displacement, amaurosis, trigeminal numbness, or dentition disruption (Gadwal et al. 2001; Patel et al. 2002a). At endoscopy, the most common appearance of sarcomas is that of a submucosal mass.
Sarcomas display a local aggressiveness and a propensity to metastasis which are correlated with the degree of differentiation rather than with histology (Pellitteri et al. 2003). Lymph node metastases are rare and typically associated with high-grade tumors. Reported rates range from 3 to 8%, with the exception of some specific histotype, such as rhabdomyo-sarcoma (Pellitteri et al. 2003). Conversely, distant metastases can occur also in low-grade neoplasms, even though with a lower rate than the high-grade counterpart (Pellitteri et al. 2003).
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