PMC7288824_01
Dorsal reconstruction at the level of the nasopharynx showing the mass filling the
choanae and partially occluding the entire rostral nasopharynx but for the narrow
gas-filled channel on the left
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CT of the head and thorax under general anaesthesia (followed by normograde and retrograde rhinoscopy) revealed an irregularly marginated contrast-enhancing expansile mixed bone and soft tissue mass filling the right nasal cavity centred at the level of the last left upper premolar, with a honeycomb-like appearance (Figure 1).
Sagittal reconstruction showing the mass filling the right nasal cavity from rostral
maxilla to choanae. The arrow indicates the fluid-filled frontal sinus
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The presence of the mass may have obstructed mucous flow from the frontal and sphenoidal sinuses on the right, resulting in the filling of both with fluid (Figure 2).
Dorsal reconstruction at the level of the orbit, showing invasion through the right
cribriform plate (arrow)
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Thinning and destruction of the cribriform plate was seen (Figure 3), along with similar changes in the frontal and palatal bones, basal lamina of the sphenoid and caudal vomer where the mass had expanded to invade the left nasal chamber, the calvarium, the left orbit and the nasopharynx (Figures 4 and 5).
Dorsal reconstruction at the level of the sphenoidal sinus, showing the mass destroying
the right frontal bone and invading the right orbit (arrowheads), and fluid filling of
the right sphenoidal sinus (arrow) due to obstruction of drainage by the mass
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Thinning and destruction of the cribriform plate was seen (Figure 3), along with similar changes in the frontal and palatal bones, basal lamina of the sphenoid and caudal vomer where the mass had expanded to invade the left nasal chamber, the calvarium, the left orbit and the nasopharynx (Figures 4 and 5).
Transverse reconstruction at the level of the cribriform plate showing the fluid-filled
left frontal sinus (F), and expansion of the mass through the left cribriform plate
(long arrow), the frontal bone on the medial aspect of the left orbit (short arrow), and
the palatal bone (arrowhead).
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Thinning and destruction of the cribriform plate was seen (Figure 3), along with similar changes in the frontal and palatal bones, basal lamina of the sphenoid and caudal vomer where the mass had expanded to invade the left nasal chamber, the calvarium, the left orbit and the nasopharynx (Figures 4 and 5).
Retrograde rhinoscopic image showing the mass obstructing the right choana and
spreading to the left
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Rhinoscopy showed a large mass lesion within the caudal nasopharynx obstructing the choana on the right and extending over to the left (Figure 6).
Photomicrograph of a biopsy sample showing soft tissues expanded by areas of moderately
cellular fibrous stroma containing multifocal areas of trabecular bone, and partially
mineralised osteoid matrix. Haematoxylin and eosin x 20
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Microscopic examination revealed parts of an expansile lesion compressing adjacent normal tissues, composed of moderately cellular fibrous stroma containing multifocal areas of trabecular woven bone and partially mineralised osteoid matrix (Figure 7).