Pathology Quiz Case 2

摘要: A 71-YEAR-OLD WOMAN PRESENTED WITH 3-month history of nasal obstruction and epistaxis in June 2003. Eleven years earlier, she had undergone 8 weeks radiotherapy to the nasopharynx neck (dosage, 72 Gy; 2 Gy per fraction) for nasopharyngeal carcinoma. Physical examination revealed a fungating, gray-tan tumor mass occupying entire chamber. Laboratory tests demonstrated lactate dehydrogenase level 140 IU/L an alkaline phosphatase 67 IU/L. Magnetic resonance imaging with intravenous gadolinium injection showed extensive heterogeneous soft tissue ethmoidal sinuses, sphenoidal sinus, chamber, invasion right orbit skull base (Figure 1). The patient then underwent craniofacial resection orbital preservation. surgical specimen malignant spindleto polygonal-shaped stromal cells pleomorphic nuclei occasional mitoses. Nests chondroid woven bone as well osteoid material were also seen around Figure 3). Adjuvant chemotherapy cisplatin (80 mg) epirubicin hydrochloride (35 was administered August However, neutropenic fever, pneumonia, acute pancreatitis developed after chemotherapy, died septic shock multiple organ failure. What is your diagnosis?