Endoscopic Transnasal Excision of Sinonasal Juvenile Fibrosarcoma: A Rare Case Report with a Suspicion of Recurrence

Abstract

ABSTRACT Juvenile fibrosarcoma (JFS) is a rare case that accounts for only 1% of all pediatric tumors, which are aggressive and fast-growing. Most arises in the distal extremities than any other parts. This case report presents the case of a 2-year-old girl with complaints of right nasal obstruction. The initial clinical impression was an antrochoanal polyp, which was further supported by radiology. Histopathology showed the appearance of rhabdomyosarcoma. After evaluation, the patient underwent endoscopic endonasal surgery (EES). However, immunohistochemistry shows positive vimentin and Ki67 that lead to the diagnosis of JFS. Six months post-EES, the evaluation showed an impression of recurrence, so revision surgery was planned. After revision, histopathology showed no tumor tissue. This case highlights the diagnosis and management in JFS, emphasizing the importance of close monitoring and follow-up. This report contributes to the understanding and management of JFS, providing insights into diagnosis and treatment strategies.