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Clinical Problem Solving
July 2013

A Nasal Mass

Author Affiliations
  • 1University of Texas–Medical Branch, Galveston
JAMA Otolaryngol Head Neck Surg. 2013;139(7):745-746. doi:10.1001/jamaoto.2013.3444

A 4-year-old, otherwise healthy boy presented with a 2-week history of a swelling over the nasal dorsum. His mother denied associated upper respiratory infection, drainage, tenderness, fever, neck stiffness, vomiting, or altered sensorium. His family history was noncontributory. An ear, nose, and throat examination revealed a small, nontender swelling over the middle part of the dorsal nasal pyramid. There was an associated sinus with a single hair protruding through it. Findings from the rest of the examination were normal. A sagittal T2-weighted magnetic resonance image (MRI) showed a bilobed cystic lesion at the nasal suture with increased signal intensity (Figure, A, arrow). A sagittal T1-weighted MRI showed the lesion to be isointense to muscle (Figure, B, arrowhead). An axial T2-weighted MRI showed a small bilobed lesion with increased intensity with a small communication between the superficial and deep components at the nasal suture (Figure, C, arrows).

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