Presentation
Six week history of rapidly growing nasal mass.
Patient Data
Large destructive mass lesion at the anterior ethmoid air cells and frontal sinuses. Peripheral irregular enhancing soft tissue appearance with central break down necrosis. It is extending bilaterally into the orbital roofs and medial orbital margin. There is bifrontal dural thickening extending along the anterior aspect of the falx cerebri. Nil intracranial mass lesion, hemorrhage or collection.
Conclusion: Appearance of the destructive mass lesion is most consistent with an aggressive carcinoma of the nasal cavity.
Case Discussion
The patient underwent fine needle aspiration biopsy of the lesion.
Histology
The smears contain abundant markedly atypical keratinizing cells occurring singly, in groups and in occasional large tissue fragments. Necrotic debris, mixed inflammatory cells and blood are in the background.
FINAL DIAGNOSIS: Squamous cell carcinoma.
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