PATHOLOGIC QUIZ CASE 1
David T. Roark, MD, Houston
A 31-year-old man had a one-year history of nasal mucoid drainage on the left side. He also experienced occasional severe frontal headaches requiring narcotics for control of the pain. Left eye blurred vision was also intermittently described for one month, but nasal bleeding, allergies, or previous such complaints were denied.
Examination was important only in evaluating the nose, where a pale red left middle meatus soft tissue mass was identified. This lesion appeared to extend superiorly within the nose and was associated with mucoid, but no purulent drainage.
Sinus films and paranasal tomograms revealed a left ethmoid mass that eroded the left medial orbital wall and a portion of the cribriform plate. The mass also extended posteriorly, destroying bone to within 1 mm of the optic foramen.
Representative microscopic sections from the removed specimen are seen in Fig 1 and 2.
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