부비동으로 침범한 전두개저에 발생한 섬유육종

Fibrosarcoma Arising in Anterior Skull Base Extending to Paranasal Sinuses

Fibrosarcomas in skull base are uncommon tumors and primary surgical resection istreatment of choice. However, it is difficult to radically resect due to limitations ofanatomical complexity, post-operative functional aspects and cosmetic problems. Weexperienced a rare case of fibrosarcoma arising from anterior skull base extending toparanasal sinuses, which was resected using bicoronal craniofacial approach withgood surgical results.A 68-year-old female suffering from intermittent headache, nasal obstruction andmucoid rhinorrhea visited neurosurgical department and initial imaging study showedirregularly enhancing mass infiltrating from left anterior skull base to nearby paranasalsinuses. She was managed by tumor resection through bicoronal craniofacialapproach, skull base reconstruction and close follow up using brain image over aperiod of one year. Pathologic finding reveals fibrosarcoma. Postoperatively, radiationtherapy was done for the remnant mass.It is also important to reconstruct skull base and isolate intracranial space from nasalcavity to prevent CSF leakage and subsequent post-operative infection.