CASE HISTORY / CLINIC:
25-year patient with severely impaired nasal breathing, increasing headache and incipient loss of visual acuity on the right side.
The nasal endoscopy revealed a round well defined reddish tumor.


FINDINGS
:
The fat suppression, contrast-enhanced T1 MRT image (upper picture) demonstrates an intensely enhancing mass with areas of low signal in the sphenoid sinus and right pterygopalatine fossa. The mass extends bilaterally (although to a greater extent on the right side) to the temporal lobes. The mass borders on the internal carotid artery both sides around the sphenoid sinus.
The coronal CT (lower picture) also demonstrates a large, strongly enhancing mass in the main nasal cavity and ethmoidal sinus (mainly the right side). The mass extends to the orbital cone and seems to spread intracranially around the lamina cribrosa. The right maxillary sinus partially appears radio-opaque suggesting fluid collection.


DIAGNOSIS:
Large nasopharyngeal fibroma


DIFFERENTIAL DIAGNOSIS:
Malignant tumor in the paranasal sinuses and main nasal cavity.



Suggestions for further reading:

1) Amersham Health


 








FINDINGS


DIAGNOSIS

DIFFERENTIAL DIAGNOSIS