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BACKGROUND: Rhinoscleroma is a chronic granulomatous disease that commonly involves the upper respiratory tract., mainly the nasopharynx. The gramnegative bacillus involved is Klebsiella rhinoscleromatis and it mainly affects women. The clinical presentation is divided into three stages: catarrhal, proliferative or granulomatous, and sclerotic. CLINICAL CASE: A 9-year-old male patient., who showed an unusual presentation of nasal rhinoscleroma, with symptoms of bilateral nasal obstruction, recurrent, epistaxis, hyposmia, and headache. The physical examination showed a sinonasal tumor and a contrasted CT was performed, finding bilateral sinonasal occupation and bone erosion, a biopsy was taken without a definitive diagnosis. It was decided to perform a combined endoscopic and bilateral Caldwell-Luc approach, obtaining histopathological results of rhinoscleroma in proliferative and scarring phase. Antibiotic treatment was started with ciprofloxacin 250 mg every 12 hours per 6 months. Three months after surgery, a gadolinium-enhanced magnetic resonance evidenced again bilateral sinonasal occupation, for which an endoscopic biopsy was performed, finding turbinoseptal synechiae, abundant fibrous tissue, septal perforation, and a cobblestone-like mucosa. The histopathological study reported rhinoscleroma again. CONCLUSIONS: In tumor conditions of the airways, it is important to consider respiratory scleroma as part of the differential diagnosis, a chronic process that requires clinical, histopathological confirmation and imaging support. [ABSTRACT FROM AUTHOR]

Introduction: a foreign body embedded in the nose can be dangerous. We present a patient in whom a button battery was detected in the nasal passages and its extraction was successful. Clinical case: seven-year-old male patient. He went to the emergency department of a secondary care hospital due to a 10-hour history with intermittent unilateral rhinorrhea in the right nostril, as well as pain. The nasal discharge was described as serous-purulent and foulsmelling. The battery was removed without complications, after being identified by x-ray. Conclusions: the extraction of foreign bodies must be rapid, particularly when it is by batteries since they can cause anything from thickening of the mucosa to perforations of the nasal septum. [ABSTRACT FROM AUTHOR]

BACKGROUND: Solitary fibrous tumor is a rare tumor that usually occurs in the pleura. It is a tumor of a mesothelial or mesenchymal cell origin. This tumor occasionally has been reported in extrapleural sites including head and neck regions. Clinically, the extrapleural lesions may be present with symptoms related to the tumor site. CLINICAL CASE: A 51-year-old female patient with progressive unilateral left-sided nasal obstruction and rhinorrhea. Nasal endoscopy and imaging exams revealed a vascular mass filling the entire left nasal cavity extending up to the nasopharynx. The tumor had marked enhancement after the administration of contrast material. Biopsy specimen examination reported solitary fibrous tumor. Immuno-histochemical analyses confirmed the diagnosis. The patient was undergone preoperative embolization with posterior tumoral excision by transpalatal approach. CONCLUSIONS: Solitary fibrous tumor of nasal cavity is a very rare illness, which is difficult to differentiate with other diseases. [ABSTRACT FROM AUTHOR]

BACKGROUND: Rhinoliths are calcified masses formed in the nasal cavity by the deposit of mineral salts. The nest of a rhinolith is usually an exogenous foreign body forgotten in the nose during childhood (seeds, beads, cotton and insects). CLINICAL CASE: A 32-year-old male patient with chronic kidney disease. We were consulted as part of the protocol for the patient’s kidney transplant. Upon questioning, the patient began his current condition 12 years ago with left nasal obstruction, with no apparent triggering cause, accompanied by anterior and posterior left nasal discharge with mucopurulent, fetid characteristics, in moderate amount, with exacerbations and partial remissions to medical treatment with multiple antibiotic regimens at unspecified doses and durations. CONCLUSIONS: Because it is a rare entity, the diagnosis of a rhinolith must have a high clinical suspicion, directing the questioning to the patient and accompanying it with imaging studies; simple computed tomography is the study of choice. Treatment must be surgical, with complete resection of the foreign body, and resolution of the complications that it has generated. [ABSTRACT FROM AUTHOR]

BACKGROUND: Extramedullary plasmocytoma is a malignant neoplasm of plasmatic cells derived from B lymphocytes, it proliferates outside the bone marrow and might be part of multiple myeloma or it can grow as a solitary neoplasm. It is exceptional to find an extramedullary plasmocytoma as a primary tumor of the nasal cavity and paranasal sinuses, representing only 1% of the head and neck tumors; 80% are located at the upper respiratory tract, of which 60% compromises the nose and paranasal sinuses. CLINICAL CASE: A 70-year-old female patient, who was admitted with mucopurulent rhinorrhea, hyposmia, nasal obstruction, headache, epiphora and blurred vision. The imaging studies showed occupation of the right nasal cavity and paranasal sinuses, as well as bone lysis and remodeling. A resection and functional endoscopic sinus surgery were performed. The diagnosis was confirmed with histopathology and the patient continued management with radiotherapy. CONCLUSIONS: The incidence of sinonasal extramedullary plasmacytoma is very rare, so it is important to consider other diagnoses, since the clinical and imaging manifestations can be non-specific. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nasal T-cell/natural killer cell lymphomas are rare, aggressive neoplasms, predominantly in males, presenting between 40 and 80 years of age. Mexico and Peru are the countries with the highest incidence in Latin America. These lymphomas have an almost exclusively extranodal presentation, the classic presentation involves palatal perforation. The most affected sites in order of frequency are the gastrointestinal tract, skin, and testicles. In the skin, the nasal cavity, nasopharynx and palate are affected. CLINICAL CASE: A 24-year-old female patient began her condition with nasal obstruction, anosmia and epistaxis, later she presented an increase in volume in the region of the right nostril, local pain, as well as fever spikes quantified up to 39°C. The tumor extended to the oral cavity and included the floor of the maxillary sinus, anterior nasal spine and the palate with an ulceration of 1 cm in its anterior portion. The histopathological study of the biopsy reported a nasal-type extranodal T/NK cell lymphoma with extensive necrosis, so it was decided to send her to the Hematology service, where chemotherapy and radiotherapy were given. CONCLUSIONS: Extranodal T/NK lymphomas are a diagnostic challenge that require a high index of clinical suspicion; the differential diagnosis includes other neoplasms, citotósuch as nasopharyngeal squamous cell carcinoma, as well as infectious processes such as fungal. In this patient, mucormycosis was suspected at first, so antifungal treatment was started without response. [ABSTRACT FROM AUTHOR]