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Minimally invasive endoscopic techniques for treating large, benign processes of the nose, paranasal sinus, and pterygomaxillary and infratemporal fossae: solitary fibrous tumour

Published online by Cambridge University Press:  11 April 2008

A Jurado-Ramos*
Affiliation:
Otolaryngology and Head and Neck Surgery Service, Reina Sofía University Hospital, Spain
F Ropero Romero
Affiliation:
Otolaryngology and Head and Neck Surgery Service, Reina Sofía University Hospital, Spain
E Cantillo Baños
Affiliation:
Otolaryngology and Head and Neck Surgery Service, Reina Sofía University Hospital, Spain
J Salas Molina
Affiliation:
Pathology Service, Reina Sofía University Hospital, Department of Medicine (Dermatology, Medicine and Otolaryngology), School of Medicine, University of Córdoba, Spain
*
Address for correspondence: Dr Alfredo Jurado-Ramos, c/ Profesor Hernández Pacheco 18, ES-14012 Córdoba, Spain. E-mail: alfredojuradoramos@hotmail.com

Abstract

Objectives:

We report an extremely rare case of a large solitary fibroma of the paranasal sinus, which we treated by sinonasal endoscopic surgery. We describe its clinical and histopathological features, and we report the endoscopic technique used to deal with such a large sinonasal mass (penetrating the pterygomaxillary and infratemporal fossae); we also offer a brief survey of the literature.

Case report:

A woman presented with an approximately one-year history of nasal obstruction. Nasal endoscopy revealed an irregularly shaped, friable, reddish mass that occupied the whole of the right nasal fossa. Magnetic resonance imaging of the paranasal sinuses revealed a large mass that occupied the anterior and posterior ethmoids and the maxillary and sphenoid sinuses, displacing the septum and penetrating the pterygomaxillary fossa, having destroyed the lateral wall of the right nasal fossa. The tumour was resected by means of sinonasal endoscopic surgery; an endoscopic medial maxillectomy with extension to the pterygomaxillary and infratemporal regions was performed. Histological analysis confirmed the diagnosis of solitary fibrous tumour. During follow up, we performed regular nasal endoscopies, as well as computed tomography scans one and six months post-operatively.

Conclusions:

Endoscopic techniques are currently the approach of choice for the treatment of such tumours of the sinonasal cavity and pterygomaxillary and infratemporal regions. The size of the lesion did not contraindicate endoscopic sinonasal surgery as a curative treatment.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2008

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