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Sachin Parikh, MD; Ingerlisa W. Mattoch, MD; Christina Kong, MD; Peter H. Hwang, MD
Stanford University School of Medicine, Stanford, California

Arch Otolaryngol Head Neck Surg. 2008;134(11):1233.

	Since this article does not have an abstract, we have provided the first 140 words of the full text and any section headings.

A 90-year old man presented with a 9-month history of chronic nasal congestion and recurrent left-sided epistaxis. He denied facial pain, headaches, or recurrent sinusitis. His medical history was notable for thrombocytopenia due to myelodysplastic syndrome. Nasal endoscopy showed an irregular purple mass emanating from the left middle meatus (Figure 1). A computed tomographic scan showed total opacification of the left maxillary sinus, with erosion of the medial, inferolateral, and posterior walls of the maxillary sinus (Figure 2).

Figure appears in full text version. Figure 1.

Figure appears in full text version. Figure 2.

A biopsy specimen was obtained from the mass. Histologic examination showed fragments of unremarkable respiratory epithelium overlying submucosa with abundant hemorrhage (Figure 3) and cholesterol clefts (Figure 4).

Figure appears in full text version. Figure 3.

Figure appears in full text version. Figure 4.

What is your diagnosis?

SECTION EDITOR: JULIA C. IEZZONI, MD

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Arch Otolaryngol Head Neck Surg. 2008;134(11):1234.
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