Pathologic quiz case. A sinonasal mass in a 79-year-old African American woman.

Abstract

79-year-old African American woman presented with a 3-week history of right-sided epistaxis, purulent rhinorrhea, and facial swelling. The patient also complained of a red bulging right eye with tearing. Her past medical history was significant for bilateral breast carcinomas treated with bilateral mastectomies (1986 and 1993) and adjuvant chemotherapy and radiotherapy. In addition, she had hypertension, obesity, diabetes mellitus, and asthma. She had smoked 2 packs per day (80 pack-years), but she had quit approximately 20 years earlier. An obvious nasal mass was noted upon examination. Magnetic resonance imaging of the sinuses demonstrated a large mass (indicated by asterisk in Figure 1) involving the right maxillary sinus and into the nasal cavity. The tumor extended to the right orbit and to the temporal and pterygoid fossae. The inframedial aspect of the right orbit and