Paranasal sinus haemophilic pseudotumor

Case contributed by Yeoh Aik Guan


Underlying hemophilia B, presented with right frontal and periorbital swelling. Proceeded with CT and MRI.

Patient Data

Age: 20 years
Gender: Male

CT scan showed dense lesion occupying the right frontal and right ethmoidal sinus with associated expansion and erosion of the sinus wall. Incidental findings of left frontal encephalomalacic changes noted.

MRI showed T1 hyperintensity which represents the blood product and with some rim of hypointensity especially at the right ethmoidal sinus which could represent a fibrotic wall. The post-contrast acquisition demonstrates heterogenous and rim enhancement attributed to blood products in varying ages of evolution 1.

Case Discussion

The initial CT scan demonstrates an aggressive lesion as evidenced by the soft tissue with an expansion of the sinus. In view of the age and underlying heamophilia, haemophilic pseudotumor would be the diagnosis until proven otherwise. This is confirmed by our MRI as well as the post-operative findings.

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