OBJECTIVE: To report a rare case of sinonasal tumor and to emphasize the importance of this tumor in the differential diagnosis, taking in account that its symptomatology is the same as that of common nasosinusal disorders. CASE REPORT: M. M. S., an 85-year-old woman and longtime smoker, presented with complaints of progressive right nasal obstruction and anosmia for 6 months that evolved with unilateral epistaxis, rhinorrhea, and oculofacial pain. The patient denied weight loss or inhalant exposure. An ear, nose, and throat (ENT) examination showed a whitish mass blocking the right nasal cavity and preventing the progression of the endoscope. Other findings included a mass in the gingival sulcus causing bulging of the right palate, a lump in the right nasal dorsum, and ipsilateral proptosis. Eye movement and visual acuity were preserved. Computed tomography (CT) of the paranasal sinuses showed a solid, heterogeneous, infiltrative mass in the right nasal cavity, extending to the floor of the right orbit, hard palate, lateral wall of the maxillary sinus, and nasal cavity. Magnetic resonance imaging (MRI) showed contact with the anterior cranial fossa and brain integrity. Biopsy of the right maxillary sinus and nasal cavity showed a high-grade sarcoma. The patient opted for a full right maxillectomy, orbital exenteration, and adjuvant radiotherapy of the ipsilateral craniofacial region. After 2 years, the patient presented a good clinical outcome and rehabilitated with multidisciplinary follow-ups. CONCLUSION: Considering that sarcoma represents less than 1% of all malignant tumors of the head and neck with survival rates less than 50% in 5 years, and the influence of early diagnosis on patient outcome, it is important to include it in the differential diagnosis of early chronic sinonasal disorders.
