Wednesday, September 10, 2008

The Nose Knows

A 15 year old male presents with severe epistaxis from the back of his nose. There is nasal obstruction, nasal drainage, serous otitis media, and diminished hearing on exam. A gadolinium enhanced T1 weighted fat saturated MRI is shown above. Although locally aggressive, histology shows this mass to be benign.

Challenge: What is it?

Image shown under fair use.

1 comment:

Craig said...

The Nose Knows

“Primary Care Otolaryngology” states that bleeding from the back of the nose in an adolescent male strongly suggests juvenile nasopharyngeal angiofibroma, a benign localized neoplasm usually arising in the lateral nasopharynx and hormonally sensitive. Biopsy is not recommended because of risk of severe bleeding.

Source: “Primary Care Otolaryngology” (AAO-HNSF); UpToDate; (original photo courtesy of Dr. Laughlin Dawes).