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Clinical Problem Solving: Pathology
September 2009

Pathology Quiz Case 2

Author Affiliations
 

JULIA C.IEZZONIMD

Arch Otolaryngol Head Neck Surg. 2009;135(9):945. doi:10.1001/archoto.2009.102-a

A 14-year-old girl presented with a 1-year history of progressive right-sided nasal congestion and sonorous evening breathing. She had no associated rhinosinusitis or atopic symptoms, denied foreign body placement, and experienced no symptomatic relief with the use of topical nasal steroid spray. Her medical history was notable for a single case of pyelonephritis. Physical examination showed a large polypoid mass obstructing her right anterior nasal cavity (Figure 1). Nasal endoscopy revealed that the mass was arising superior to the right inferior turbinate. Noncontrast computed tomography of the nose and sinuses demonstrated a 4.6 × 0.7 × 4.4-cm partially mineralized right nasal soft-tissue lesion (Figure 2). The mass abutted and displaced the vertical strut of the right middle turbinate laterally, contacted the septum medially, and extended superiorly to, but did not breech, the cribriform plate.

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