Congenital Midline Nasal Masses: Diagnosis and Management

Kennard, Charles D.; Rasmussen, James E.

doi:10.1111/j.1524-4725.1990.tb00327.x

Cited by 42 publications

(36 citation statements)

References 57 publications

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“…2 Approximately 25 percent of nasal gliomas have a dural connection 3 ; as a result, one of the risks of surgical intervention is inadvertent contamination of the cranial contents. A meningoencephalocele appearing in this anterior location is nearly always recognized in infancy, 4 and defects in the cribriform plate and frontal bone are consistent findings. Neither was apparent in this case, ruling out that diagnosis.…”

Section: Ifferential D Iagnosismentioning

confidence: 71%

Case 14-1995

Cotton¹,

Goodman²

1995

N Engl J Med

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A 12-year-old boy was admitted to the hospital because of an obstructive right nasal mass.The patient had been in excellent health until two years earlier, when he began to have right nasal obstruction that gradually worsened. Occasional bouts of epistaxis occurred; right-sided headaches appeared and interfered with his attendance at school and concentration. Treatment for sinusitis on several occasions and the topical use of beclomethasone did not result in improvement. Four months before admission an otolaryngologist detected an obstructive polypoid mass within the right nasal cavity. Axial and coronal computed tomographic (CT) sections of the paranasal sinuses ( Fig. 1), obtained after the intravenous injection of contrast material, showed an expansile mass within the right nasal cavity that caused displacement of the nasal septum to the left, bulged into the right maxillary ostium, and extended into the lower right ethmoid sinus. The membranes of the right antrum and ethmoid sinus were thickened. The medial wall of the right orbit was slightly displaced laterally. The mass did not extend into the nasopharynx. Microscopical examination of a small biopsy specimen of the mass revealed fibrous proliferation with vascular spaces. The findings were considered suggestive, but not diagnostic, of a juvenile nasopharyngeal angiofibroma.Nine weeks before admission the patient was referred to this hospital. On physical examination he appeared thin but well, with hyponasal speech and nasal congestion. No craniofacial dysmorphism was evident. The ears were normal. There was fullness in the right lateral nasal and malar region. A polypoid mass completely obstructed the right nasal passage and deviated the nasal septum so that it abutted the left inferior turbinate. The palate was normal, and mirror examination of the nasopharynx disclosed adenoid tissue, without additional masses. The tonsils were small, and no lym-phadenopathy was found. Magnetic resonance imaging (MRI) studies ( Fig. 2 and 3), performed before and after the administration of gadolinium, showed a mass, 4 by 3 cm, in the right nasal cavity with a low signal intensity on the T 1 -weighted images and a high signal in-The New England Journal of Medicine Downloaded from nejm.org at STOCKHOLMS UNIVERSTITETSBIBL on August 11, 2015. For personal use only. No other uses without permission.

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Section: Ifferential D Iagnosismentioning

confidence: 71%

Case 14-1995

Cotton¹,

Goodman²

1995

N Engl J Med

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“…The most common are dermoid cysts, encephaloceles, and nasal gliomas. Less often, a midline nasal mass represents an epidermoid cyst, hemangioma, lacrimal duct cyst, ethmoidal cyst, meningocele, lipoma, papilloma, cartilaginous tumor, metastatic carcinoma, or teratoma (2–4). Gliomas, encephaloceles, and midline dermoid cysts result from faulty embryologic development and have potential intracranial connections.…”

Section: Discussionmentioning

confidence: 99%

Congenital Midline Nasal Mass in a Toddler

Yashar

Newbury²,

Cunningham

2000

Pediatric Dermatology

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“…A mass or a sinus tract is seen, along the path of regression of the dural diverticulum anywhere from the columella to anterior cranial fossa. 58,59,63 Associated skin dimpling, tuft of hair or sinus tract can be seen. Dermoid cysts contain ectoderm with skin appendages, unlike epidermoid which contain only ectodermal elements.…”

Section: Congenital Nasofrontal Massesmentioning

confidence: 98%