Clinical and Endoscopic Findings

In the initial phase, the lesion may be asymptomatic or may cause aspecific symptoms. Subsequently, patients usually complain of local pain, nasal obstruction, epistaxis, headache, and progressive anosmia. Moreover, different ocular signs and symptoms (i.e., epiphora, recurrent dacryocystitis, blurry vision, proptosis, diplopia, alteration of the extraocular motility, central scotomas, decreased visual acuity, retroorbital headache, and even blindness) may occur (Kimmelman et al. 1982; Som et al. 1991; Patel et al. 1993; Citardi et al. 1996; Chateil et al. 1997; Saito et al. 1998; Pasquini et al. 2002). Very rarely the lesion can present with meningitis and/or pneu-mocephalus due to intradural extension (Saito et al. 1998).

Physical examination generally shows a submuco-sal expansile lesion with different location (maxilla, medial ocular canthus, frontal bone, cheek) depending on the site of origin (PateL et al. 1993; CitarDi et al. 1996; Suzuki et al. 2001).

Nasal endoscopy may reveal only a mild mucosal congestion of the lateral nasal wall. In other cases, it shows a fleshy mass in the nasal cavity or a pinkish bulging of the medial wall of the maxillary sinus with secondary deflection of the nasal septum (HaDy et al. 1990; Som et al. 1991; PateL et al. 1993; Pasquini et al. 2002).

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