PMC5130329_01
CT showing a soft tissue mass from the right nasal cavity extending to the posterior ethmoid air cells. Inflammatory changes are present to the right sphenoid sinus.
can-10-692fig1.jpg
PMC5130329_01_can-10-692fig1.jpg
figure1
No lymphadenopathy was identified (Figure 1).
MRI (a) T1WI showing mainly hypointense mass in the right nasal cavity and posterior ethmoid air cells with retained secretions and inflammatory changes to the left ethmoid air cells (b) T1WI GD axial and (c) Coronal images showing the expansive soft tissue mass well-defined with intense enhancement (d) T2WI sagittal plane showing high signal intensity of the lesion.
can-10-692fig2.jpg
PMC5130329_01_can-10-692fig2.jpg
figure2
T1-weighted images following intravenous administration of gadolinium. The signal was heterogeneous on T2-weighted images (Figure 2a-d).
(a) Tumour of the nasal mucosa with moderate cellularity composed of ovoid to spindle cells with ovoid bland nuclei (H+E X 100) (b) Tumour cells are positive for vimentin (Immunostain X 200) (c) Tumour cells are focally positive for SMA (Immunostain X 200) (d) Few tumour cells are positive for CD34 (Immunostain X 200) (e) tumour cells show moderate to strong nuclear positivity for beta-Catenin (ImmunostainX200) (f) Tumour cells of the nasal mucosa (H+E).
can-10-692fig3.jpg
PMC5130329_01_can-10-692fig3.jpg
figure3
Immunohistochemistry showed positivity to vimentin, SMA, with few cells positive with CD34 and negative reactions with S-100 protein, desmin, and myogenin (Figure 3a-f).
DSA (a, b) angiography showing branches of the right sphenopalatine artery (c, d) angiography after embolisation showed complete devascularisation of the tumour.
can-10-692fig4.jpg
PMC5130329_01_can-10-692fig4.jpg
figure4
The angiographic control demonstrated arterial supply to the mass by both internal maxillary arteries (Figure 4a, b). Tokyo, Japan). The vessels were embolised with microparticles measuring 350-500 mum in size (Embospheres, Boston Scientific, Massachusetts, USA ). The final angiographic control showed complete devascularisation of the tumour (Figure 4c, d).
Intraoperative photograph showing the lesion arising from the middle turbinate.
can-10-692fig5.jpg
PMC5130329_01_can-10-692fig5.jpg
figure5
The lesion arose from the middle turbinate and extended to the anterior wall of the sphenoid sinus (Figure 5).