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


 






FINDINGS



DIAGNOSIS

DIFFERENTIAL DIAGNOSIS