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Chronic sinusitis with intra-sinus calcification

Case contributed by Heba Abdelmonem
Diagnosis probable

Presentation

Chronic headache

Patient Data

Age: 20 years
Gender: Female

Both maxillary sinuses are small in size. Nearly complete opacification of the examined sinuses seen filled with soft tissue masses associated with rarefied sinus walls, middle nasal turbinates as well as the nasal septum. Bilateral intra-sinus egg-like calcific lesions near the sinus wall, the largest on the right side. Both ostiomeatal units are obliterated. Hypertrophied inferior nasal turbinates.

Case Discussion

Intrasinus calcification may be a differentiating point between fungal and chronic sinusitis. The pattern and site of calcification in nonfungal cases are away different from those of fungal sinusitis. Calcification in fungal infection is located at the maxillary sinus antrum, whereas the calcification in non-fungal sinusitis is usually peripherally located, near the sinus wall. Fine punctuate calcifications are almost seen in fungal sinusitis, however well marginated, round, or eggshell calcification is only seen with a nonfungal disease.

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