Multimodality Imaging Evaluation of an Uncommon Benign Nasal Cavity Tumor
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Multimodality Imaging Evaluation of an Uncommon Benign Nasal Cavity Tumor Case Report on Angioleiomyoma of the Nasomaxillary Junction Ayman Nada1
· Faraaz Salik1 · Roopa Bhat1 · Humera Ahsan1
Received: 26 May 2020 / Accepted: 16 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Introduction A sinonasal angioleiomyoma is a rare benign tumor of the nasal cavity [1, 2]. Angioleiomyoma is composed of smooth muscles around vascular spaces [3, 4]. The most common locations in the head and neck region include the nasal cavity, lip and auricle [3]. The first described case was reported in 1966 by Maesaka et al. [2]. We present a case of nasomaxillary angioleiomyoma with a brief review of the literature and description of its imaging features.
Case Summary A 69-year-old man was referred to the otolaryngology clinic for persistent nasal congestion and left-sided facial fullness refractory to antibiotics. On further investigation the patient had a 10-year history of progressively worsening left-sided cheek fullness associated with left jaw and tooth pain. The patient denied any history of rhinorrhea, postnasal drip or snoring. He had a remote history of trauma when he had The abstract has been accepted for electronic presentation at American Society of Neuroradiology (ASNR) meeting 2020 Ayman Nada
[email protected] Faraaz Salik [email protected] Roopa Bhat [email protected] Humera Ahsan [email protected] 1
his nose broken twice in a high school boxing match. Past medical history was remarkable only for chronic obstructive pulmonary disease (COPD), hypertension (HTN) and depression. Otolaryngological examination revealed a large well-demarcated, reddish polypoid mass lesion attached to the anterior portion of lateral wall of the left nasal vestibule. This mass caused partial nasal obstruction due to near location to the left nasal aperture. Associated mild right septal deviation was noted. No significant oral or nasopharyngeal extension of the mass was observed. Fiber optic endoscopic laryngopharyngoscopy was performed in the clinic which confirmed the large well-circumscribed reddish polypoid mass attached the lateral wall of left nasal vestibule. The mass was again noted to cause partial nasal obstruction with thick mucoid drainage. Blood parameters were normal, and complete blood count (CBC) was without evidence of leukocytosis.
Computed Tomography A computed tomography (CT) scan of the paranasal sinuses was subsequently carried out to enable a better evaluation and delineate the nasal mass. A CT scan of the paranasal sinuses without intravenous contrast agent was obtained which showed a well-circumscribed hypodense mass, centered on the left nasomaxillary junction (Fig. 1). This nasomaxillary mass lesion was associated with scalloping, remodeling, and minimal resorption of adjacent medial maxillary wall and mass effect on the nasal septum. Findings were concerning for a giant cell granuloma and an MRI was recommended for better char
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