Abstract

Introduction: Head and neck sarcomas in adults are rare with an incidence of less than 5%. They usually occur in the skull base, maxilla and larynx. Chondrosarcomas are derived from chondrocytes, embryonal rests, or mesenchymal cells. With only 2 reported cases, chondrosarcomas of the nasal tip is fairly out of the common. We hereby report an uncommon case of grade I chondrosarcoma of alar cartilage of nose. Case Report: A 72-year-old woman, presented with a history of swelling over nasal tip for 15 years. It gradually increased in size over a period of 6 months. Fine Needle Aspiration Cytology from the lump was suggestive of chondroid syringoma. Capsular dissection of the mass was done along with primary closure of the wound. On histopathological examination it was diagnosed to be a case of grade I chondosarcoma with no tumor deposit in the resection margins. Discussion: The primary challenge was to differentiate grade I chondrosarcoma from enchondroma. In our case the tumor revealed infiltrative properties and cytological atypia on microscopic examination. Further immunohistochemistry for S100 was positive which confirmed the presence of chondrocytes. Hence, we arrived at a diagnosis of grade I chondrosarcoma. Closest differential diagnosis of grade III chondrosarcoma is chondroblastic osteosarcoma,which shows osteoid formation. Conclusion: Chondrosarcoma of nasal tip is very rare, and it is uncommon in females. Surgical resection of the tumor is the mainstay for treatment of chondrosarcoma. Adjuvant therapies may be used in high grade chondrosarcomas. Prognosis of grade I chondrosarcomas is fairly good, but as the grade increases prognosis becomes poor.