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Clinical Problem Solving: Radiology
April 2005

Radiology Quiz Case 1

Author Affiliations

Hospital Clinic, Barcelona, Spain

 

R. NICKBRYANMDPATRICIA A.HUDGINSMD

Arch Otolaryngol Head Neck Surg. 2005;131(4):366. doi:10.1001/archotol.131.4.366

A 15-year-old girl presented with acute dyspnea and a 3-minute loss of consciousness that resolved spontaneously. She had a 1½-year history of nasal obstruction, sleep apnea, “hot potato voice,” dysphagia, anterior rhinorrhea, and hyposmia. She had lost 10 kg over the last year. Her medical history was negative for asthma and aspirin intolerance.

A skin prick test demonstrated a positive response to house dust mites. Physical examination showed a soft mass hanging from the nasopharynx, totally occupying the oropharynx and thereby preventing laryngoscopic examination. Rhinoscopy showed a mass filling the right nasal cavity. A computed tomographic scan of the paranasal sinuses demonstrated obstruction of the right maxillary sinus and a mass extending from the right nasal cavity into the nasopharynx and oropharynx, down to the level of the epiglottis (Figure 1 and Figure 2). A 2-dimensional re-formation showed the cranial-caudal extent of the benign water density mass (Figure 3).

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