PMC5824506_01
Profile picture showing clinical presentation preoperatively
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F1
On examination, a diffuse swelling was present over the right periorbital area, infraorbital region extending up to the upper lip and right alar margin and posteriorly up to the right tragus of the ear [Figure 1].
Axial computed tomography scan section showing involvement of right maxillary sinus
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F2
Diagnostic magnetic resonance imaging (MRI) was performed to determine the source and extent of the persistent facial soft-tissue swelling, which revealed mucosal thickening with polyposis involving the right maxillary, frontal, ethmoidal and sphenoidal sinuses with destruction of anterior and posterior walls of the right maxillary sinus and the hard palate, with involvement of the right orbit, infratemporal fossa and superior orbital fissure [Figures 2-4].
Coronal computed tomography scan section showing involvement of the right maxillary sinus and presence of a soft-tissue mass
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F3
Diagnostic magnetic resonance imaging (MRI) was performed to determine the source and extent of the persistent facial soft-tissue swelling, which revealed mucosal thickening with polyposis involving the right maxillary, frontal, ethmoidal and sphenoidal sinuses with destruction of anterior and posterior walls of the right maxillary sinus and the hard palate, with involvement of the right orbit, infratemporal fossa and superior orbital fissure [Figures 2-4].
Sagittal computed tomography scan section showing involvement of ethmoidal and frontal
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F4
Diagnostic magnetic resonance imaging (MRI) was performed to determine the source and extent of the persistent facial soft-tissue swelling, which revealed mucosal thickening with polyposis involving the right maxillary, frontal, ethmoidal and sphenoidal sinuses with destruction of anterior and posterior walls of the right maxillary sinus and the hard palate, with involvement of the right orbit, infratemporal fossa and superior orbital fissure [Figures 2-4].
Endoscopic view of granulomatous tissue in the right maxillary sinus
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F5
Through a diagnostic transnasal endoscopic approach, the right maxillary sinus was viewed which revealed a brownish granular mass [Figure 5].
Histopathological pictures showing Langhan's cell at x100
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F6
AB-PAS and Grocott's special staining were carried out to diagnose tuberculosis and rule out fungi infection [Figures 6 and 7]. A routine posterior-anterior view chest radiograph was taken which showed no evidence of pulmonary involvement leading to the inference that with the presenting features and histopathological examination, the Maxillary sinus could be the primary site of involvement.
Histopathological pictures showing Tubercle granuloma at x100
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F7
AB-PAS and Grocott's special staining were carried out to diagnose tuberculosis and rule out fungi infection [Figures 6 and 7]. A routine posterior-anterior view chest radiograph was taken which showed no evidence of pulmonary involvement leading to the inference that with the presenting features and histopathological examination, the Maxillary sinus could be the primary site of involvement.