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55 Year-old Patient with Intranasal Mass
David W Kennedy1, Robert Brody2
1Rhinology Professor, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104.
International Forum of Allergy & Rhinology
|January 10, 2018
Summary
A delayed diagnosis of an intranasal mass led to significant progression. Recurrence after surgery, presenting as pulsatile clear mucus, suggests a possible meningo-encephalocele requiring further investigation.
Area of Science:
- Otolaryngology
- Neurosurgery
- Pathology
Background:
- A 55-year-old female presented with a right intranasal mass in 2014.
- The patient initially declined recommended surgery, leading to a three-year delay in treatment.
- Significant lesion progression was noted upon her return.
Purpose of the Study:
- To identify the nature of the intranasal mass.
- To determine the appropriate management strategy for the advanced lesion.
- To diagnose and manage a potential cerebrospinal fluid (CSF) leak post-resection.
Main Methods:
- Initial presentation and delayed follow-up assessment.
- Surgical resection of the intranasal mass.
- Post-operative nasal endoscopy to evaluate for complications.
Main Results:
- The intranasal mass showed significant progression over three years.
- Post-resection, the patient developed pulsatile clear mucus, indicative of a potential complication.
- The findings raise suspicion for a meningo-encephalocele.
Conclusions:
- Delayed treatment of intranasal masses can lead to advanced disease.
- Post-operative pulsatile clear discharge warrants investigation for cerebrospinal fluid leak.
- A meningo-encephalocele is a significant concern requiring prompt evaluation and management.
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