Esthesioneuroblastoma

Abnormal enhancing T2 hypointense material that spans right middle ethmoid air cells and the upper extreme of the right nasal cavity, with obstruction of the right frontal and sphenoid sinuses are at least partial obstruction of the right maxillary sinus. There is a defect in the anterior cranial fossa floor in the region of the right cribriform plate, through which there is a subtle bulge of tumor resulting in indentation of the under surface of right gyrus rectus. There is smooth overlying dural enhancement. No convincing evidence that tumor has extended beyond dura. No evidence of orbital extension, although medial, orbital wall is broadly abutted by tumor in ethmoid. No evidence of perineural spread. A prominent vessel, most likely a developmental venous anomaly, is incidentally noted in the left paramedian frontal lobe.

Conclusion: Right sinonasal mass eroding cribriform plate with superior bowing of overlying dura. This is most likely an esthesioneuroblastoma. Nasopharyngeal carcinoma is less likely in this age group, but could be considered given ethnic background. Lymphoma would typically have very low ADC values, and juvenile nasopharyngeal angiofibroma typically enhances more vividly, is centered differently and has a slightly younger demographic peak.

Opacification of the right upper nasal cavity and ethmoidal air cell without overt bony destruction.  No infiltration into the orbit.