Interesting case of fibroma sphenoid sinus

Clinical details:

18 years old boy came with c/o blocking sensation both nasal cavity - 1 year duration

Decreased sensation of smell - 6 months duration

He gave h/o repeated attacks of upper respiratory infection

He gave no h/o bleeding from nose

No h/o head ache

On examination:

Anterior rhinoscopy:

A pale mass could be seen occupying the posterior portion of right nasal cavity.

Post nasal examination:

The same mass could be seen occupying the nasopharynx occluding both choana.

CT scan nose and paranasal sinuses plain / contrast were taken.

It showed non enhancing mass arising from sphenoid sinus entering the post nasal space and the posterior portion of right nasal cavity



This patient was taken up for endoscopic sinus surgery and the mass was removed completely in toto.

Histopathology report - fibroma

Fibroma involving sphenoid sinus and post nasal space are commonly vascular (angiofibroma). In this case the fibrous elements
predominated and hence the mass was not enhancing in contrast CT. There was no abnormal bleeding during surgery.

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