Nasal Cavity Masses: Clinico-Radiologic Collaborations, Differential Diagnosis by Special Clues

Duzgun Yildirim, Omer Saglam, Berk Gurpinar, Turan Ilica

Department of Head and Neck Surgery, Kasimpasa Military Hospital, ?stanbul, Turkey.
Department of Radiology, Gulhane Military Medical Academy, Ankara, Turkey.
Department of Radiology, Iskenderun Military Hospital, Hatay, Turkey.

DOI: 10.4236/ojmi.2012.21002                

Abstract

Purpose: Nasal cavity may contain wide variety of masses within, that differs this organ from the rest of the body. Primary nasal cavity masses consist of 0.2% - 0.8% of all malignancies. This paper aims to emphasize the main characteristics of different nasal cavity masses on cross-sectional images which may cause symptoms varying from simple nasal obstruction to metastatic invasion. We tried to solve the diagnostic bias by focusing on the special clues with the aid of the striking images caused by the same appearence of nasal cavity masses on cross-sectional radiologic images. Materials and Method: 66 retrospective dataset of patients (male: 35, female: 31, mean age: 43 years) were reviewed by the cross-sectional images. All cases had nasal passage obstruction and all cases had previously undergone maxillofacial imaging (computerized tomography, CT (n = 43); magnetic resonance imaging, MRI (n = 21); positron emmision tomography, PET/CT (n = 2)). Results: Totally, 48 benign and 18 malignant cases which have distinct pathologies were reviewed. All the lesions occupying space through the nasal cavity were demonstrated on cross-sectional images. With the typical cross-sectional images, an algoritm was made to help the differential diagnosis and presented as a scheme to presume the most feasible diagnosis. Conclusion: Sinunasal masses may have the worst prognosis on late diagnosis because of the probability of early invasion of the basicranial structures or cranial nerves. Verification of the neoplasm by the specific cross-sectional images, either benign or malignant, could be done at once.

Keywords

Nasal Cavity; Neoplasms; Imaging; Differential Diagnosis

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	M. F. Mafee, “Nonepithelial Tunlors of Tile Paranasal Sinuses and Nasal Cavity: Role of CT and MR Imaging,” Radiologic Clinics of North American, Vol. 31, No. 1, 1993, pp. 75-90.
[2]	R. L. Carrau, E. N. Myers and J. T. Johnson, “Paranasal Sinus Carcinoma Diagnosis, Treatment, and Prognosis,” Oncology, Vol. 6, No. 1, 1992, pp. 43-50.
[3]	J. D. Spiro, K. C. Soo and R. H. Spiro, “Non Squamous Cell Malignant Neoplasms of the Nasal Cavities and Paranasal Sinuses,” Head Neck, Vol. 17, No. 2, 1995, pp. 114-118.
[4]	P. M. Som and H. D. Curtin, “Inflammatory Lesions and Tumors of the Nasal Cavities and Paranasal Sinuses with Skull Base Involvement,” Neuroimaging Clinics of North American, Vol. 4, No. 3, 1994, pp. 499-513.
[5]	M. D. Murphey, E. A. Walker, A. J. Wilson, M. J. Kransdorf, H. T. Temple and F. H. Gannon, “Imaging of Primary Chondrosarcoma: Radiologic-Pathologic Correlation,” RadioGraphics, Vol. 23, No. 5, 2003, pp. 1245-1278. doi:10.1148/rg.235035134
[6]	S. Safder, J. S. Carpenter, T. D. Roberts and N. Bailey, “The ‘Black Turbinate’ Sign: An Early MR Imaging Finding of Nasal Mucormycosis,” American Journal of Neuroradiology, Vol. 31, No. 4, 2010, pp. 771-774. doi:10.3174/ajnr.A1808
[7]	L. Migirov, M. Drendel and Y. P. Talmi, “Osteoma in an Aerated Middle Nasal Turbinate,” Israel Medical Association Journal, Vol. 11, No. 2, 2009, p. 120.
[8]	A. Dragonetti, R. Gera, A. Sciuto, A. Scotti, A. Bigoni, E. Barbaro and A. Mini, “Sinonasal Inverted Papilloma: 84 Patients Treated by Endoscopy and Proposal for a New Classification,” Rhinology, Vol. 49, No. 2, pp. 207-213.
[9]	K. Motoori, S. Yamamoto, T. Ueda, K. Nakano, T. Muto, Y. Nagai, et al., “Interand Intratumoral Variability in Magnetic Resonance Imaging of Pleomorphic Adenoma: An Attempt to Interpret the Variable Magnetic Resonance Findings,” Journal of Computer Assisted Tomography, Vol. 28, No. 2, 2004, pp. 233-246. doi:10.1097/00004728-200403000-00014
[10]	D. J. Howard, G. Lloyd and V. Lund, “Recurrence and Its Avoidance in Juvenile Angiofibroma,” Laryngoscope, Vol. 111, No. 9, 2001, pp. 1509-1511.
[11]	Y. Noorizan, H. Salina, “Nasal septal haemangioma in pregnancy,” Medical Journal of Malaysia, Vol. 65, No. 1, 2010, pp. 70-71.
[12]	I. J. Wang, S. L. Lin, K. I. Tsou, M. C. Hsu, W. T. Chiu, S. H. Tsai, et al., “Congenital Midline Nasal Mass: Cases Series and Review of the Literature,” Turkish Journal of Pediatrics, Vol. 52, No. 5, 2010, pp. 520-524.
[13]	S. M. Allbery, G. Chaljub, N. L. Cho, C. H. Rassekh, S. D. John and F. C. Guinto, “MR Imaging of Nasal Masses,” RadioGraphics, Vol. 15, No. 6, 1995, pp. 1311-1327.
[14]	R. L. Carrau, E. N. Myers, J. T. Johnson, “Paranasal Sinus Carcinoma Diagnosis, Treatment, and Prognosis,” Oncology, Vol. 6, No. 1, 1992, pp. 43-50.
[15]	J. D. Spiro, K. C. Soo and R. H. Spiro, “Nonsquamous Cell Malignant Neoplasms of the Nasal Cavities and Paranasal Sinuses,” Head Neck, Vol. 17, No. 2, l995, pp. 114-118.
[16]	G. Hartig, K. Montone, M. Wasik, A. Chalian and R. Hayden, “Nasal T-Cell Lymphoma and the Lethal Midline Granuloma Syndrome,” Otolaryngology—Head and Neck Surgery, Vol. 114, No. 4, 1996, pp. 653-656. doi:10.1016/S0194-5998(96)70264-4
[17]	K. R. Cleary and J. G. Batsakis, “Sinonasal Lymphomas,” The Annals of Otology, Rhinology & Laryngology, Vol. 103, No. 11, 1994, pp. 911-914.
[18]	S. Ciolofan, E. Ioni??, C. A. Mogoant?, F. C. Popescu, F. Anghelina, L. Chiu?u, G. Stanciu, et al., “Malignant Melanoma of Nasal Cavity,” Romanian Journal of Morphology and Embryology, Vol. 52, No. 2, pp. 679-84.
[19]	B. D. Nguyen, M. C. Roarke, K. D. Nelson and B. W. Chong, “F-18 FDG PET/CT Staging and Posttherapeutic Assessment of Esthesioneuroblastoma,” Clinical Nuclear Medicine, Vol. 31, No. 3, 2006, pp. 172-174. doi:10.1097/01.rlu.0000200735.55296.73
[20]	H. Boo and J. P. Hogg, “Nasal Cavity Neoplasms: A Pictorial Review,” Current Problems in Diagnostic Radiology, Vol. 39, No. 2, 2010, pp. 54-61. doi:10.1067/j.cpradiol.2009.07.001
[21]	M. Y. Padmanabhan, R. K. Pandey, A. Kumar and V. Tandon, “Oral & Maxillofacial Manifestations in Pediatric Esthesioneuroblastoma-Report of a Case and Review of Literature,” Pediatric Dentistry, Vol. 33, No. 3, 2011, pp. 261-264.
[22]	A. Almuhaideb, R. Syed, L. Iordanidou, Z. Saad and J. Bomanji, “Fluorine-18-Fluorodeoxyglucose PET/CT Rare Finding of a Unique Multiorgan Involvement of Wegener’s Granulomatosis,” The British Journal of Radiology, Vol. 84, No. 1006, 2011, pp. 202-204. doi:10.1259/bjr/22598605