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Clinical Problem Solving
May 2014

A Rare Sinonasal Entity

Author Affiliations
  • 1Lenox Hill Hospital, New York, New York
  • 2New York University Hospital, New York
JAMA Otolaryngol Head Neck Surg. 2014;140(5):477-478. doi:10.1001/jamaoto.2014.334

A woman in her 70s with a history of radiation therapy for a nasal cavity lymphoma 15 years prior presented with complaints of chronic right nasal obstruction and right epiphora. She denied epistaxis or pain. She described having undergone 2 surgical procedures in the interim for occluded nasolacrimal duct, at 1 year and 8 years after treatment.

On nasal endoscopy, a smooth, pink, friable mass was seen abutting the posterior aspect of the right inferior turbinate and extending to fill most of the nasopharynx. This mass was visible through the left choana as well. There was also an erythematous irregular area, smaller than 1 cm, on the right lateral nasal wall, corresponding to the orifice of the nasolacrimal duct. The middle turbinates were intact, and no other lesions were seen. The oropharynx and oral cavity were clear, and findings from fiber-optic laryngoscopy was normal. Orbital examination revealed right epiphora without additional abnormality.

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