Giant intranasal mass in children: don t forget the obvious

Introduction Intranasal masses in pediatric age are mostly benign pathologies derived from nasal mucosa. Concha Bullosa (CB), a common entity in adult age, is rarely diagnosed in children as intranasal mass with airway obstruction.

Case Report An 11-year-old patient was referred to our tertiary clinic for evaluation of a unilateral endonasal mass. The parents reported nasal obstruction and recurring nasal discharge. On physical examination a round mass covered with healthy mucosa in der left nasal vestibule was visible. It could not be passed with an endoscope.

MR Imaging was done to rule out possible intracranial connection. MRI confirmed an intact cranium and showed hyperintense giant mass attached to lateral nasal wall in T2-weighted images and low signal intensity in T1-weighted images. These findings were consistent with a CB.

Therapy The patient underwent an endoscopic operation under general anesthesia. After puncture incision on frontal side of the mass an aerated concha media with mucopurulent content was confirmed. Lateral laminectomy was performed.

In the postoperative follow-up three months after surgery the patient was free of symptoms.

Discussion CB is one of the most common anatomic variations of lateral nasal wall and remains generally asymptomatic. Extraordinary large CB with complete nasal obstruction as in our case become symptomatic in early age.

Endoscopic resection of the lateral wall of CB is a safe and efficient treatment, also in children.

Poster-PDF A-1724.PDF

Publication History

Article published online:
10 June 2020