PATHOLOGIC QUIZ CASE 1
James S. Reilly, MD, John S. Supance, MD, Pittsburgh
An 8-month-old male infant was examined at the Otolaryngology Ambulatory Care Facility, Children's Hospital of Pittsburgh, for progressive left-sided facial asymmetry of three months' duration. There was no history of infection or trauma. Pertinent physical findings were limited to the head and neck. An intraoral examination disclosed a firm, nontender mass that arose from the inferomedial aspect of the left maxilla, involved the alveolar ridge, and protruded into the gingivobuccal sulcus. The mucosa was intact, and the mass was nonpulsatile. Extraoral palpation showed the mass to extend superiorly toward the left nasal bone and medially to the lateral nasal wall, with distortion of the left nasal ala and upper lip. Facial function and results of cranial nerve assessments were normal. There was no epiphora, proptosis, or evidence of infection. Facial bone roentgenograms showed an expansile, lucent lesion