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Clinical Problem Solving: Pathology
April 2004

Pathology Quiz Case 2

Author Affiliations
 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2004;130(4):475. doi:10.1001/archotol.130.4.475

An 85-year-old man presented with a 3-month history of congestion and epistaxis in his right nasal cavity. His medical history was unremarkable except for hypertension. Clinical examination revealed a nasal obstruction. A computed tomographic scan showed an expansive mass involving the right inferior turbinate and the homolateral ethmoidal region (Figure 1). Surgery was performed with the patient under general anesthesia. The following technique was used: nasal flap rotation and exposure of the neoplastic mass, "box" resection of the right lateral nasal cavity and nasal septum, and partial medial maxillectomy. Macroscopically, the lesion appeared as a 2 × 3-cm, blue-black, ulcerated mass extensively infiltrating the inferior turbinate but apparently sparing the bone (Figure 2). The reconstruction of the nasal pyramid was achieved through nasal flap rotation fixed with a titanium miniplate. The histologic findings are shown in Figure 3 and Figure 4.

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