Introduction: Synovial sarcomas are malignant soft tissue tumors usually occurring in adolescent and young adults of 15-40 years of age. It usually originates from the synovium but sometimes have a tendency to arise from unknown parasynovial tissues as parapharyngeal, paranasal, retroperitoneal and mediastinal regions. Paranasal sinuses are rarely involved subsites of head and neck region. Case Report: We report case of a 55-year-old hypertensive patient who presented with intermittent nasal bleeding. Computed tomography (CT) scan suggests left anterior ethmoidal mass with anterior cranial fossa extension. Biopsy was suggestive of synovial sarcoma. She had history of polyp extraction two times but biopsy was suggestive of inflammatory origin. This patient received EBRT 50Gy in 25 fractions. No recurrence was noticed in one year follow up. Conclusion: We report unusual ethmoid sinus synovial sarcoma masquerading as chronic sinusitis in an elderly female patient, unlikely age presentation.
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