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Sinonasal Squamous Cell Carcinoma


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Sinonasal Squamous Cell Carcinoma

Elliot K. Fishman, MD
Director of Diagnostic Imaging and Body CT, Professor of Radiology and Radiological Science, Johns Hopkins
Karen M. Horton, MD
Professor and Interim Chair, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins

There is a large T1 isointense, T2 hypointense, mildly enhancing mass in the right nasal passage extending posteriorly to fill the nasopharynx and bowing the nasal septum leftward. There is mass effect and displacement of the right maxillary sinus medial wall into the sinus cavity with small areas of dehiscence in the posterior aspect secondary to the mass. The inferior aspect of the right ethmoid sinuses are involved and are expanded and right medial and inferior turbinates can not be visualized separate from this mass compatible with osseous and soft tissue destruction. The mass obstructs the right maxillary sinus, visualized right ethmoid sinuses, right sphenoid and right frontal sinuses. This pattern is consistent with a sinonasal malignancy which on biopsy turned out to be a squamous cell carcinoma (SCCa), the most common sinonasal malignancy. As seen here, SCCa does not enhance to the degree of adenocarcinoma, melanoma, or esthesioneuroblastoma and is relatively T2 hypointense.