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July 19, 2010

Radiology Quiz Case 2: Diagnosis

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Arch Otolaryngol Head Neck Surg. 2010;136(7):742-743. doi:10.1001/archoto.2010.97-b

Diagnosis: Juvenile nasopharyngeal angiofibroma (JNA), Radkowski grade Ib

The MRIs (Figure 2and Figure 3) revealed a heterogeneous solid and cystic mass expanding the left nasal cavity, with the cystic components of the mass containing fluid-fluid levels suggestive of hemorrhage. Images obtained after gadolinium administration demonstrated robust mass enhancement. The mass appeared to originate from the left sphenopalatine foramen, without significant pterygopalatine fossa or skull base extension. The tumor did not involve the cavernous sinus (data not shown). The computed tomographic findings complemented the MRI results by demonstrating mass erosion of the left inferior sphenoid wall and some associated remodeling of the left sphenoethmoidal recess (Figure 4).

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