Uncommon and Atypical Sinonasal Masses: Diagnostic and Therapeutic Challenges

Introduction: Sinonasal masses are a wide range of pathologies ranging from simple nasal polyps to rare tumors like esthesioneuroblastomas. Early symptoms of all of them are similar to common nasal and sinus problems, hence, producing a delay in diagnosis. Materials and methods: All the patients presenting with sinonasal masses in the Department of ENT and Head/Neck Surgery, SRMS Institute of Medical Sciences, Bareilly, were included in the study. The study was carried out between January 2007 and December 2011. Detailed history and ENT examination were recorded. Radiological investigation was carried out in the form of computed tomographic (CT) scan of nose and paranasal sinuses. Final diagnosis was made by histopathological examination either before instituting any form of treatment or by a postsurgical biopsy where surgery was carried out. Immunohistochemistry was done in some cases as deemed necessary by the pathologist. Thus, their modes of presentation, radiological and histopathological profiles were studied along with dilemmas in diagnosis and management. Results: A total of 189 nasal masses were observed during this period. Out of which 126 were diagnosed as nasal polyps and were excluded from the study. Thus, 63 uncommon nasal masses were seen in the study period. A large number of uncommon sinonasal masses had atypical presentation and/or presented in an advanced stage to pose a diagnostic and surgical challenge. Endoscopic techniques are becoming a gold standard in surgical resection in most of them. Interdepartmental cooperation is highly essential.