Nodular fasciitis of the sphenoid sinus presenting with a visual field defect: A case report

Nodular fasciitis (NF) is a self-limiting mesenchymal neoplasm. Although it can occur in various parts of the body, its presence within the sphenoid sinus is extremely rare in adults. To the best of our knowledge, only one other case has been reported in the English literature. Because of its rapid growth and potential to mimic malignant tumors, accurate diagnosis and timely treatment are essential.

We report a case of a 58-year-old man who presented with visual disturbance in the right eye. Computed tomography and magnetic resonance imaging revealed a mass lesion in the sphenoid sinus, with erosion of the bony wall of the right optic nerve canal. The mass was completely removed through an endoscopic transnasal transsphenoidal approach, both for histopathological diagnosis and optic nerve decompression. Pathological examination confirmed the diagnosis of NF. Postoperatively, the patient's visual field improved significantly.

This case highlights NF as a rare but important differential diagnosis in patients presenting with visual impairment due to a mass in the paranasal sinus. In symptomatic cases, early surgical intervention should be considered to prevent symptom progression and ensure an accurate diagnosis.