History of intermittent blood-tinged mucoid discharge and congested breathing, of 2-3 months duration. Physical exam showed minimal airflow through both nostrils. CBC and chemistry were WNL.
History of intermittent blood-tinged mucoid discharge and congested breathing, of 2-3 months duration. Physical exam showed minimal airflow through both nostrils. CBC and chemistry were WNL.
CT of the skull: Nasal Cavity: Primarily right-sided mass effect; soft tissue attenuating, causing
turbinate destruction, deviation and destruction of the boney nasal septum, extending
into left nasal cavity (minimally), causing multifocal lysis of the nasal vault.
Frontal sinuses: severe involvement of the right side, complete occlusion of lumen,
lysis of the dorsal frontal bone.
Calvarium: Normal.
Brain: Lysis of the right cribriform plate and extension of the mass into the brain. No
deviation of the falx cerebra.
Lymph nodes: Enlarged right retropharyngeal LN (R=8 mm, L=3mm).
Soft tissues are normal
Recommendations: Rhinoscopy for biopsy confirmation. Consider radiation therapy consultation/referral
R/O tumor vs infectious vs fungal vs other