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This was a teenager who was having recurrent epistaxis.

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On the VIBE axial scan, or T1-weighted axial scans,

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we see a mass that's in the nasal cavity

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projecting into the nasopharynx. Pertinently,

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it is not invading the maxillary sinus

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or the ethmoid sinus, so it's limited

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to the nasal cavity. On the T2-weighted scan,

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heterogeneous, but usually just dark

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in signal intensity predominantly.

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But one sees a lesion

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that is avidly enhancing.

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Now, I don't see a lot of big blood vessels

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in this lesion that might suggest that this

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was a juvenile nasopharyngeal angiofibroma.

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But given the patient's age and the clinical history

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and the avid enhancement, that's the most likely

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diagnosis. Because it is limited to the nasal cavity,

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we have a Kadesh

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type 1 lesion, or stage one lesion. It has not grown

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into the paranasal sinuses and is only in the nasal

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cavity and projecting to the nasopharyngeal phoena.

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Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Mahla Radmard, MD

Postdoctoral Research Fellow

Johns Hopkins University School of Medicine

Tags

Sinus

Sinonasal Cavity

Oncologic Imaging

Neuroradiology

Neoplastic

MRI

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