Different Faces of Sinonasal Mass Lesions

Abstract

Introduction

Mass in the nasal cavity presents with a wide range of symptoms, when a presumptive diagnosis is often made with the help of imaging and endoscopy. This study focussed on correlating clinical diagnosis with the histopathological diagnosis so that appropriate treatment can be offered to improve the quality of life of the patient.

Materials and Methods

The study included 120 cases who presented with symptoms and signs of mass in the nasal cavity, undergoing surgery or diagnostic biopsy. They were evaluated with a detailed history and clinical examination, diagnostic nasal endoscopy, and relevant radiological investigations. Histopathological examination of the biopsy of the excised specimen was performed by Haematoxylin and Eosin stain. Special stains and Immunohistochemistry (IHC) were performed whenever indicated. The clinical diagnosis was correlated with histopathological diagnosis.

Results

Nasal obstruction was the most frequent symptom followed by nasal discharge. Non-neoplastic lesions made up 85% of cases, while16% of cases were proved as neoplastic lesions. Among neoplastic lesions, 7% were benign, and 9% were malignant.  The inflammatory polyp was the most common non-neoplastic lesion. Fischer's exact test showed a correlation between clinical diagnosis and histopathological diagnosis. Non-neoplastic lesions were common in the 4th decade of life; benign lesions were common in the 3rd decade of life, while malignant lesions were common in the 5th decade of life.

Conclusion

Sinonasal masses present with overlapping clinical features, and sometimes the definite diagnosis is possible only by histopathological examination of the specimen. However, in the presence of characteristic clinical features, accurate clinical diagnosis is possible in most cases, and appropriate treatment can be performed without delay, pending histopathological examination.