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Clinical Problem Solving: Pathology |

Pathology Quiz Case

Jonathan G. Thomas, BA; Oscar B. Lahoud, BS; P. Daniel Ward, MD; Jonathan B. McHugh, MD; Melissa A. Pynnonen, MD
Arch Otolaryngol Head Neck Surg. 2008;134(7):783. doi:10.1001/archotol.134.7.783.
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A 70-year-old woman presented with a 3-year history of a large left nasal mass as well as associated unilateral nasal obstruction and rhinorrhea. Her medical history was notable for a nasal polypectomy 20 years earlier. Physical examination revealed that the mass completely filled the left nasal cavity, expanding the ala and protruding beyond the left nasal vestibule. Indirect examination showed a large mucosal-covered lesion filling the left nasopharynx.

Bone window coronal sections of a maxillofacial computed tomogram demonstrated a mass filling the left nasal cavity from the anterior naris to the posterior choana, with remodeling of the nasal cavity (Figure 1). Biopsy revealed a benign-appearing lesion with evidence of chronic sinusitis, and the patient was scheduled for operative resection. During surgery, the firm, fibrous, and minimally vascular mass was found to be attached to the inferior turbinate by a narrow pedicle (Figure 2).

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