FREDERIC B.ASKINMDWILLIAM H.WESTRAMD
A 65-YEAR-OLD black woman presented with a 6-month history of right-sided facial and neck pain with associated headaches. She had no history of epistaxis, dysphagia, odynophagia, migraine, or cluster headaches. She was started on multiple trials of nonsteroidal anti-inflammatory drugs, without relief of symptoms. Her physical examination revealed no abnormalities in the head or neck. The results of a nasopharyngoscopic examination were also normal. A computed tomographic (CT) scan of the paranasal sinuses without contrast revealed a mass arising from the right alveolar ridge and extending into the right maxillary sinus (Figure 1). The mass exhibited calcifications in both peripheral and central portions, without associated osseous destruction, periosteal reaction, or fat attenuation. The remaining paranasal sinuses were normal, as were the turbinates, nasal septum, and ostiomeatal complexes.
Grafenberg MR, Kim S, Sorensen D. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2002;128(9):1100-1102. doi: