Home⇛Philippine Scientific Journal⇛vol. 56 no. 2 (2023)

Benign Hematoma - Like Mass of the Maxillary Sinus (HLMMS) with Malignant Features: A Case Report

Norizcelle Pearl A. Bartolome

Discipline: medicine (non-specific)

 

Abstract:

Objective: To report a case of a benign hematoma-like tumor of the maxillary sinus mimicking a malignant lesion and to discuss the clinical presentation, ancillary procedures, and management. Methodology Design: Case study Setting: Tertiary hospital Patient: 1 Case Report R.T., a 41-year-old female consulted due to a right intranasal mass. Four years ago, the patient experienced nasal congestion associated with headache and yellowish, blood-tinged nasal discharge. Patient consulted ENT physician and PNS CT scan done with unrecalled results while biopsy revealed chronic inflammation. She was given Co-Amoxiclav with no improvement and was advised surgery. During the interim, the intranasal mass enlarged associated with nasal obstruction, headache, nasal discharge, cheek pain, epistaxis, and dyspnea. The patient consulted our institution wherein nasal endoscopy revealed smooth, erythematous, fleshy, non-friable mass occupying the right nasal cavity with yellowish blood-tinged foul-smelling nasal discharge. Punch biopsy of the nasal mass revealed sinonasal polyps while PNS CT Scan showed a large 6.1 x 6 x 4.8 cm expansile soft tissue mass occupying the right maxillary sinus and right nasal cavity. The mass effaces the left nasal cavity and abuts the medial wall of the left maxillary sinus. The patient underwent anteromedial maxillectomy with no complications. Histopathology revealed a neoplasm composed of dilated and congested vessels with neovascularization hemorrhage and fibrin exudation or deposition. The rest of the hospital stay was unremarkable, and she was discharged on the 8th hospital day. Conclusion Hematoma like mass of the maxillary sinus (HLMMS) is a rare benign maxillary tumor which should be considered in the differential diagnosis of patients presenting with expansile maxillary sinus tumors with malignant features. Diagnosis should be established to rule out carcinoma



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