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Clinical Problem Solving: Pathology
May 18, 2009

Pathology Quiz Case 1

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Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Otolaryngol Head Neck Surg. 2009;135(5):520-523. doi:10.1001/archoto.2009.37-a

A 78-year-old woman presented with a 2-month history of recurrent left epistaxis. She had no history of nasal obstruction, nasal discharge, facial pressure, or headache. She had a history of hypertension, but she was otherwise healthy. Endoscopic evaluation revealed a violaceous pedunculated soft-tissue mass arising from the left posterior septum and sphenoethmoidal recess. The findings of a comprehensive head and neck examination were otherwise unremarkable. A computed tomographic scan of the sinuses revealed soft-tissue opacification of the posterior left nasal passage, without bony expansion or erosion (Figure 1). A biopsy performed at another center revealed that the soft-tissue mass was a benign lesion with features suggestive of a glomus tumor. Reportedly, the biopsy produced considerable bleeding, which required the placement of dissolvable nasal packing. The patient was subsequently referred to our institution for evaluation.

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