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Diagnostic dilemma - sinonasal organizing hematoma
Joel James1, Austin J Shackelford2, David A Gudis3
1City University of New York School of Medicine, New York, USA.
SAGE Open Medical Case Reports
|August 22, 2020
Summary
Sinonasal organizing hematomas are benign lesions that mimic malignancy on imaging, causing diagnostic challenges. Increased clinician awareness is crucial for accurate diagnosis and patient prognosis.
Area of Science:
- Otolaryngology
- Pathology
- Radiology
Background:
- Sinonasal organizing hematomas (SOH) are rare, benign lesions.
- They can present aggressively, mimicking malignant sinonasal tumors.
- Diagnostic challenges arise from imaging and endoscopic findings.
Observation:
- A 56-year-old male presented with left nasal obstruction and epistaxis.
- CT imaging showed left maxillary sinus opacification, orbital wall erosion, and nasal cavity extension.
- The presentation suggested advanced disease, leading to potential diagnostic deception.
Findings:
- SOH can exhibit destructive features on imaging.
- Rarity and aggressive appearance contribute to misdiagnosis.
- Endoscopic intervention is a definitive management option.
Implications:
- Enhanced awareness of SOH among clinicians is needed.
- Accurate diagnosis improves patient prognostic counseling.
- This entity should be considered in the differential diagnosis of sinonasal masses.
