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Clinical Problem Solving: Radiology
December 2004

Radiology Quiz Case 4

Author Affiliations
 

NICK R.BRYANMDPATRICIA A.HUDGINSMD

Arch Otolaryngol Head Neck Surg. 2004;130(12):1445. doi:10.1001/archotol.130.12.1445

A 19-year-old man presented with a 5-month history of progressively increasing swelling of the left side of his cheek and left-sided nasal obstruction. He also stated that he had experienced pain in the left side of his face for 1 month and had lost a tooth in the left upper jaw. He had no history of visual disturbance or nasal discharge.

Clinical examination revealed a bony, hard swelling over the left maxilla. Examination of the oral cavity revealed the loss of the first molar in the left upper jaw. The mass involved the left half of the hard palate and theleft upper alveolus. Nasal endoscopy showed the mass bulging into the left inferior meatus. The overlying mucosa was normal. The nasal septum was in the midline. A computed tomographic scan revealed a 6 × 5-cm hyperdense ossified mass completely filling the left maxillary antrum (Figure 1). The mass extended into the floor of the orbit, pterygoid plates, zygoma, inferior turbinate, upper alveolus, and hard palate on the left side. An associated soft tissue component was also seen predominantly in the buccal space (Figure 2). A biopsy specimen was obtained from the mass.

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