Case 217: Sinonasal Organized Hematoma

Organized hematoma of the sphenoid sinus with epistaxis

“…Imaging findings of OH are internally heterogeneous, reflecting pathological bleeding and fibrous changes [12] , [13] , [14] , [15] . In typical cases, T1-weighted MRI shows heterogenous intensity and T2-weighted MRI contains high-intensity and hypointense peripheral rim [ 1 , 2 , 4 , 6 , 14 , [16] , [17] , [18] ] and, as in our case, helped for the diagnosis of OH [17] . Previous studies reported that the frond-like pattern of contrast enhancement is one of the characteristic imaging findings of OH that helps to differentiate from other simulating lesions [ 13 , 17 ].…”

“…In typical cases, T1-weighted MRI shows heterogenous intensity and T2-weighted MRI contains high-intensity and hypointense peripheral rim [ 1 , 2 , 4 , 6 , 14 , [16] , [17] , [18] ] and, as in our case, helped for the diagnosis of OH [17] . Previous studies reported that the frond-like pattern of contrast enhancement is one of the characteristic imaging findings of OH that helps to differentiate from other simulating lesions [ 13 , 17 ]. In our case and the previous reports [2] , [3] , [4] , [5] , the sphenoid impact was only one side, but possible factors that influenced this were unknown.…”

Diagnostic dilemma – sinonasal organizing hematoma

“…A discerning neuroradiologist, however, will identify imaging findings of an expansive soft-tissue mass, smooth sinonasal wall dehiscence, marked heterogenous signal intensity with a hypointense peripheral rim on T2-weight MR imaging to appropriately diagnoses SOH. 7,8 Complete endoscopic excision is curative for SOH, although prior to widespread adoption of an endoscopic approach reports in the literature detail the use of Caldwell-Luc, lateral rhinotomy, and Denker’s procedures. 1…”

Sinonasal organized hematoma: Case report and review of the literature

“…The CT appearance of this condition is nonspecific; however, an expansile mass with surrounding osseous destruction is typical [ 6 , 9 ]. MRI is superior to CT for determining the margin and extent of the lesion with the added benefit of confidently differentiating between the lesion and secretions within opacified, obstructed sinuses [6] .…”