Intranasal Mass Research Articles

A case of nasal glioma in a new-born infant

We report a 1 day old girl with a nasal mass that was diagnosed as an intranasal glioma. The tumor mass was noted to be localized laterally from, and based along, the inferior turbinate. Nasal glioma is a developmental abnormality of neurogenic origin with no malignant potential. An intranasal mass requires careful rhinological, neurological and radiological examinations. With adequate initial removal, excisional biopsy usually allows complete recovery. A frontal craniotomy approach is preferred for those patients who have nasal glioma with an intracranial connection. With no evidence of an intracranial connection, a conservative extracranial approach is recommended.

Endoscopic marsupialization of bilateral lacrimal sac mucoceles with nasolacrimal duct cysts

A lacrimal sac mucocele is an uncommon disease usually treated by ophthalmologists. In rare cases, it is sometimes associated with a nasolacrimal duct cyst presenting as an intranasal cystic mass, which needs the involvement of an otolaryngologist in diagnosis and management. Two cases of lacrimal sac mucoceles with nasolacrimal duct cysts are presented with a brief literature review. Both cases presented with intranasal cystic masses that caused nasal obstruction and were cured with endoscopic marsupialization of the cysts.

A Proposal for a Staging System for Hyperplastic Rhinosinusitis Based on the Presence or Absence of Intranasal Polyposis

This study of 30 patients with hyperplastic rhinosinusitis reveals that the major determinant of the success or failure of conservative therapy is the presence or absence of intranasal polyposis. When polyposis is confirmed both clinically and radiographically, surgical intervention appears to be the rational way to handle most cases. When intranasal polyps are not present, an aggressive medical regimen is called for, one that includes a short-term, low-dose oral corticosteroid and an antibiotic, along with periodic radiographic assessment. Regardless of how much disease is seen on computed tomography, if it does not also detect intranasal polyps or masses, the potential for clearing with conservative therapy is extremely high.

Chondroid hamartoma presenting as a neonatal nasal mass

We present a case of a 3-month-old female with a right nasal mass. Upon evaluation with computed tomography, magnetic resonance imaging and angiography, a large right intranasal mass extending through the cribiform plate, displacing the dura, was noted. The patient underwent a combined midfacial degloving and bifrontal craniotomy for complete resection of the tumor mass. Pathologic evaluation demonstrated a mesenchymal tumor with spindle and stellate cells from which islands of immature cartilage emerged. The spectrum of histologic features closely resembled a mesenchymal chondroid hamartoma typically located in the chest wall. It is the first reported case of a chondroid hamartoma of the head and neck in the literature to date. We examine the characteristics and treatment of this unusual tumor.

Benign mixed tumour (pleomorphic adenoma) of the nasal cavity.

A 48 year old Muslim female patient came with complaints of a slowly enlarging polypoidal mass with obstructive symptoms in the leR nostril of six months duration, but no history of epistaxis. She was a known patient of allergic rhinitis for which she was taking anti-allergies for the past twenty years. There was no history of prior intranasal surgery and no family history of similar problem. X-ray nose and para-nasal sinuses revealed an expanding soft tissue intra-nasal mass on left side without sinus involvement. The turnout was removed by wide surgical excision with a provisional clinical diagnosis of Allergic Polyp and sent for histopathological examination. During surgery the tumour was found to originate from the mucosa of the bony nasal septum.

巨大な胞状上鼻甲介(superiorconchabullosa)例

A concha bullosa is an aerated turbinate. It is the most common anatomic variant of the middle turbinate. Inferior concha bullosa is a less frequent anatomic variation. Recently we treated a patient with a massive superior concha bullosa with an infection which mimicked a nasal tumor.A 16-year-old boy presented with a right nasal obstruction. He had no medical history of nasal problems. On physical examination a large, firm, nonpulsatile mass was found to fill his right nasal cavity. A CT scan revealed a large intranasal bony rimmed mass. MR imaging showed a cyst-like mass in the right nasal cavity with secondary obstruction of a part of the right posterior ethmoid sinus. We thought that the mass was a massive, infected concha bullosa at the time of examination. A subsequent biopsy revealed a thin, bone-lined, hollow cavity filled with whitish mucopurulent material. A CT scan examined three months later revealed that this extraordinary spreading bullous concha originated from the inner aspect of the right superior turbinate and that the opening of the concha bullosa was the posterior ethmoid air cell. It was evident that the mass was in fact a superior concha bullosa. Nearly the entire wall of the superior concha bullosa was removed by endoscopic technique.

38: Current Concepts in Radiologic Assessment of Intranasal Masses

38: Current Concepts in Radiologic Assessment of Intranasal Masses

비강 및 부비동에 범발한 혈관종

Hemangiomas involving the paranasal sinuses are rare. They are described to be a well circumscribed, intensely enhancing mass, causing benign appearing bone changes at CT scan. We report 4 cases of hemangiomas involving the nasal cavity, maxillary sinus, and ethmoidal sinus, presented with refractory epistaxis, and easily bleeding, friable intranasal mass. CT scan showed a large, inhomogenously enhancing mass with significant bone erosion, which made it difficult to differentiate hemangiomas from the most common malignant epithelial tumors on the basis of the imaging findings. Medial maxillectomy by midface degloving, rather than lateral rhinotomy with lip splitting, was recommended for surgical excision. Major intraoperative bleeding was avoided by the use of adjunctive preoperative embolization or by intraoperative ligation of the external carotid artery.

Esthesioneuroblastoma presenting as an orbital mass in a young child

A 3-year-old boy presented with uniocular proptosis and ophthalmoplegia. Investigation revealed a mass involving the right orbit with extension into the left orbit and paranasal sinuses, and intracranial extension involving both frontal lobes. Biopsy of an enlarged cervical node and the intranasal mass revealed esthesioneuroblastoma. This tumor has been reported rarely in a child this age, and only 12 case reports document patients under 10 years of age. The presentation as an orbital mass is previously unreported and must now be considered in the differential diagnosis of proptosis in childhood. The usual clinical, radiological, and pathological features of olfactory esthesioneuroblastoma are reviewed.

Septal Pleomorphic Adenoma Masquerading as Squamous Cell Carcinoma

A 43-year-old woman had left midfacial pain and a left intranasal mass. Pathologists from three different institutions agreed that the biopsy specimens from the mass represented squamous cell carcinoma. The final pathologic diagnosis made from the resected specimen was pleomorphic adenoma of the septum. This report describes a case which was initially misdiagnosed on the basis of misleading tissue biopsy results, but the excised tumor was finally diagnosed as pleomorphic adenoma. Otolaryngologists treating an intranasal mass must be aware of the difficulty of correctly diagnosing the initial tissue biopsy specimen in order to guard against unnecessary radical surgery.

Neonatal respiratory distress: sequela of bilateral nasolacrimal duct obstruction

Neonatal respiratory distress is a commonly seen entity whose causes are legion. Nasal obstruction secondary to intranasal masses is significant because neonates are obligate nasal breathers. Congenital nasolacrimal duct obstruction (NLDO) causing respiratory distress is an extremely rare event since most cases of NLDO do not compromise the nasal airway. We report two cases of neonatal respiratory distress secondary to bilateral NLDO with cystic mucocele formation and intranasal extension; only two similar cases have been previously described. Pertinent embryology and anatomy are reviewed as is a brief discussion of congenital NLDO. MRI and a nasal endoscopic photograph are provided demonstrating the nasolacrimal and nasal pathology. Treatment strategies are outlined. Consideration of nasolacrimal duct pathology in the differential diagnosis of neonatal respiratory distress and nasal obstruction is stressed.

鼻前庭側壁に生じた多形腺腫例

Pleomorphic adenoma usually occurs in the salivary gland. Occurrence in the nasal cavity is very rare and none have been reported in the vestibule of the nose.A very rare case of pleomorphic adenoma in the right vestibule of the nose in a 62-yearold woman is reported. The mass was 2.5 cm×2.0 cm and was located under the right lateral cutis. The mass was surgically removed via an intranasal approach. Histopathological examination showed similarities to pleomorphic adenoma of the salivary gland. Origin of this pleomorphic adenoma seemed to be the anterior nasal gland because of its location.Previous reports of nasal pleomorphic adenoma are also reviewed. There were 41 prior cases in Japan. Most nasal pleomorphic adenoma is in the nasal septum. Only 4 cases were located on the lateral side of the nose.Differential diagnosis of intranasal masses is discussed. Reticulum cell sarcoma, hemangioma, melanoma and Wegener's granulomatosis occur more frequently than pleomorphic adenoma. Biopsy is the most reliable method of diagnosis, but there are two contradictory opinions about biopsy. One is that, biopsy should be performed to rule out malignancy. The other is that biopsy should not be done because it may cause concretion of nasal mucosae. Therefore, we thought that biopsy should be done only after careful clinical examination.

Unilateral congenital nasolacrimal mucocele

A case of a congenital nasolacrimal mucocele is reported. This very uncommon finding presents usually with a diagnostic triad on CT: an intranasal cystic mass, a dilated nasolacrimal duct and lacrimal sac.

Congenital Nasolacrimal Duct Cysts in Dacryocystocele

Cystic intranasal masses were found in seven newborn infants with congenital dacryocystocele. The cysts were a direct extension of the nasolacrimal duct, located beneath the inferior turbinate. Nasal obstruction was present in three infants and was severe enough to cause respiratory distress in two neonates with bilateral cysts. Using fiberoptic nasal endoscopy, treatment consisting of probing, irrigation, and marsupial ization of the cysts was successful in all infants. The authors believe this rarely reported anomaly is a more common finding in dacryocystocele than previously recognized and advocate careful nasal examination in all infants with congenital dacryocystocele. Early diagnosis and treatment of this condition is critical in the infant with nasal obstruction.

“Pleomorphic adenoma of nasal septum”

Mixed salivary tumours have been found to arise almost everywhere in the upper alimentary and respiratory tract like lips, tongue, floor of mouth, tonsils, cheek, alveolar ridge, soft and hard palate, pharynx and larynx. It is, however, uncommon in the nasal cavity. Most commonly pleomorphic adenoma arises from nasal septum. Macroscopically they present as a intranasal mass without any specific feature. Diagnosis is essentially by histopathological examination. Their theories of origin have been discussed along with the treatment.

Congenital nasolacrimal mucoceles: CT evaluation.

A congenital nasolacrimal mucocele, a lacrimal sac mucocele with intranasal extension, is an uncommon mass arising in the medial canthal region of the orbit. The authors describe four infants who presented with medial canthal masses and nasal airway obstruction. All underwent computed tomographic (CT) evaluation, which revealed the triad of cystic dilatation of the lacrimal sac, dilatation of the nasolacrimal duct, and an intranasal cystic mass. Appropriate therapy was determined following identification of the intranasal cystic component. Relevant discussions of the embryology, clinical presentation, and the characteristic CT findings of infants with congenital nasolacrimal mucoceles are included.

Nasal presentation of an intracranial vascular anomaly

Intracranial vascular anomalies uncommonly present as a nasal mass. We report the first documented intranasal extension of a venous angioma of the anterior and middle cranial fossas. The diagnostic evaluation and differential diagnosis of an intranasal vascular mass is emphasized. In addition, recommendations are offered regarding the surgical approach of such a lesion.

ｎａｓａｌ ｇｌｉｏｍａの一例

Nasal glioma has been thought to be usually benign and composed of ectopic glial tissue and found at birth extranasally and or i.ntranasally.In Japan nasal glioma situated both extranasally and intransally (mixed type nasal glioma) has never been reported. Recurrence is rare if the first removal of the tumor is adequate. We report a case of mixed type nasal glioma which recurred 8 months after the first resection of the intranasal masses.

Neonatal respiratory distress secondary to nasal fibrous histiocytoma

A full term one-day-old neonate developed respiratory distress secondary to a right intranasal mass. After exploratory craniotomy revealed no intracranial lesions, the child was observed for 6 months. At that time he experienced severe apnea with cyanosis necessitating removal of the mass, which was histologically as a fibrous histiocytoma. Seven year follow-up reveals no further problems. A discussion of fibrous histiocytoma of the nose and paranasal sinuses is briefly given.

The nasolabial cyst-nasal hamartoma.

The nasolabial cyst is an uncommon midfacial cyst. Twenty-six patients with nasolabial cysts were treated at the New York Eye and Ear Infirmary from 1969 to 1986. Most of these lesions manifested facial deformity, unilateral nasal obstruction, and pain when infected. The nasolabial cyst is often unrecognized or confused with other intranasal masses, or fissural and odontogenic cysts. Infection of these lesions--which occurred in 50% of the patients--may mimic facial cellulitis, periodontal abscess, acute maxillary sinusitis, or nasal furuncles. This cyst is considered to be a hamartoma because of its developmental origin from entrapped epithelium in an embryonic fusion plane. Simple aspiration invariably leads to recurrence, and complete surgical excision is the accepted treatment. The nasolabial cyst should be considered in the differential diagnosis of intranasal masses, midface infections, and swelling in the nasolabial area.