CASE
HISTORY / CLINIC:
Patient with loss of the sense of smell (anosmia) for many months, severe impairement
of nasal breathing and headache of increasing severity over the frontal sinuses.
FINDINGS:
The contrast-enhanced, fat suppression T1 image (upper picture) demonstrates
a large contrast-enhancing
mass lesion in the frontal sinus, ethmoidal cells and on both sides of the
nasal cavity. It's quite impossible to draw a clear-cut demarcation to the right
orbita and frontal lobe. The mass
in the ethmoidal cells demonstrates low intensity in the axial T2-weighted
image (lower picture). A clear-cut demarcation to the orbital cone and smell
brain is likewise not possible here.
DIAGNOSIS:
Extensive squamous cell carcinoma in the frontal sinuses, ethmoidal sinus and
the nasal cavity involving invasion of both orbitas and intracranial spread.
DIFFERENTIAL DIAGNOSIS:
Other malignant mass lesions such as esthesioneuroblastoma or adenocarcinoma.
Suggestions for further reading:
1) Roche Lexikon Medizin
2) Pathologie Online
3) AWMF
4) Aco.at