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July 1990

Resident's Page

Arch Otolaryngol Head Neck Surg. 1990;116(7):860-863. doi:10.1001/archotol.1990.01870070108021

PATHOLOGIC QUIZ CASE  Thomas M. Andrews, MD, Charles M. Myers III, MD, Cincinnati, OhioAn 11-year-old girl presented with a history of a previous admission for Streptococcus pneumoniae bacteremia presumably secondary to a right-sided pansinusitis (Fig 1). A computed tomographic scan demonstrated a bony mass in the right ethmoidal sinus expanding into the maxillary sinus and impinging on the lamina papyracea without evidence of destruction (Fig 2). Examination at the initial evaluation revealed an intercanthal distance of 38 mm, a mild headache, and proptosis of the right eye.A bone scan demonstrated increased uptake in the medial aspect of the right orbit and ethmoidal sinus, consistent with an osteoclastic lesion.The patient was taken to the operating room, where a lateral rhinotomy and an external ethmoidectomy revealed a blue-gray mass, which was completely excised. Figure 3 is a representative photomicrograph of the lesion.What is your diagnosis?