PMC4319355_01
Extraoral photograph of the patient showing lobulated swelling on right side of face
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F1
Extraoral examination [Figure 1] was suggestive of a lobular swelling on the right side of the face extending from infraorbital margin to the lower border of mandible supero-inferiorly and from ala of nose and corner of the mouth to tragus of ear and ramus of mandible anteroposteriorly approximately 7 cm x 8 cm in size.
Intraoral photograph of the patient showing generalized brown discoloration of teeth lobulated surface of right buccal mucosa
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F2
Intraoral examination [Figure 2] revealed generalized brownish discoloration of teeth in a linear fashion along the cervical third of teeth with high arched palate.
Orthopantomograph of the patient showingeffacement of right maxillary alveolus, maxillary sinus, zygomatic arch and adjacent maxillary structures by the soft tissue mass with resorption of anterior border of ramus
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F3
Orthopantomogram [Figure 3] showed erosion of the alveolar bone in relation to maxillary first molar region and maxillary tuberosity on the right side along with resorption of the anterior border of ramus and the effacement of right maxillary sinus, zygomatic arch and adjacent maxillary structures by the soft tissue mass without the presence of any well-defined lesion.
Axial computed tomography image showing bowing of anterior wall of right maxillary sinus (arrow) by the enhancing soft tissue mass known as Hollman Miller's sign
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F4
Contrast enhanced CT revealed a large, ill-defined enhancing soft tissue mass filling the nasopharynx, bilateral nasal cavity [Figures 4 and 5], and pterygopalatine fossa and sphenopalatine foramen extending into ethmoid and sphenoid sinus with erosion of its lateral wall and floor.
Axial computed tomography image showing ill-defined enhancing soft tissue mass filling nasopharynx (black arrow), bilateral nasal cavity with deviation of nasal septum (red arrow) and erosion of right medial pterygoid plate (black dashed arrow)
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F5
Contrast enhanced CT revealed a large, ill-defined enhancing soft tissue mass filling the nasopharynx, bilateral nasal cavity [Figures 4 and 5], and pterygopalatine fossa and sphenopalatine foramen extending into ethmoid and sphenoid sinus with erosion of its lateral wall and floor.
Axial computed tomography image showing extension of soft tissue component into right buccal space and infratemporal space (arrow) with remodeling of mandible
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F6
There was an extension into soft tissue component into right buccal space and the infratemporal space [Figure 6] with associated mass effects giving an impression of nasopharyngeal angiofibroma.
Axial T2-weighted magnetic resonance image showing hyperintense large lobulated enhancing soft tissue mass causing expansion of pterygopalatine fossa and sphenopalatine foramen with extension into sphenoid sinus, ethmoid air cells and right nasal cavity, maxillary sinus and infratemporal fossa
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F7
The mass was seen as hypointense on T1-weighted image and heterogeneously hyperintense on T2-weighted image [Figure 7] causing expansion of pterygopalatine fossa and sphenopalatine foramen with extension into the sphenoid sinus, ethmoid air cells and right nasal cavity.
Magnetic resonance imaging angiogram showing the lesion to be supplied by external carotid artery (arrow)
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F8
The mass was supplied by the right external carotid artery [Figure 8].