R. NICKBRYANMDPATRICIA A.HUDGINSMD
A 27-year-old woman was referred for evaluation of a right-sided intranasal mass. Her medical history was significant for recurring unilateral nasal obstruction, sinus infections, epistaxis, and headaches. She also had a history of hyponatremia and seizures due to SIADH (syndrome of inappropriate antidiuretic hormone). A biopsy was performed after an attempt at surgical excision failed because of severe intraoperative hypertension. The results of immunohistochemical staining of the intranasal specimen were positive for the following components: synaptophysin, chromogranin, CD56, S100 protein, glial fibrillary acid protein, and neurofilament. Further workup for the episode of severe hypertension disclosed elevated 24-hour urinary catecholamine levels and mild tracer uptake in the right nasal region on iobenguane I 131 scan. The patient was then referred to our medical center for subsequent treatment.
Nabili V, St. John M, Cohan P, Lufkin R, Bhuta S, Abemayor E. Radiology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2006;132(3):342. doi:10.1001/archotol.132.3.342