0:01

Well, this is a sarcoma where we may be able

0:03

to make a specific diagnosis.

0:05

We see that the lesion is centered on the nasal septum.

0:10

We see that the lesion has some matrix to it,

0:15

which is calcified.

0:17

Maybe some people would call this a

0:20

popcorn like calcification,

0:22

but it's a midline lesion with expansile margins

0:25

and not all that aggressive.

0:27

You see that there's bony remodeling rather than through

0:31

and through erosion

0:32

and aggressive destruction of the walls

0:36

of the maxillary antrum.

0:38

Here in the anterior portion of the junction

0:41

between the maxillary sinus

0:43

and the nasal bones, it has lower

0:46

density on the CT scan,

0:49

and this is a patient who has a chondro sarcoma

0:53

of the nasal septum.

0:54

An MRI scanning these lesions,

0:57

although they may have dark signal from the matrix on the

1:01

T two weighted skin, they are usually very bright in signal

1:04

intensity, and that's true both in the clus as well

1:07

as along the nasal septum.

1:10

What's in the differential diagnosis for a midline lesion,

1:12

which may have some calcified MA matrix?

1:16

Well, this is what one can see with those

1:20

nut carcinomas.

1:21

The nuclear protein in testis,

1:24

that has been described in the cy nasal cavity as well.

1:28

So when it's chondro and it's popcorn

1:30

and it's pretty classic, you would suggest a chondro sarcoma

1:34

when it's got fine calcification

1:37

and is again associated with the nasal septum.

1:40

Differential diagnosis might include the nut carcinoma.

1:44

Let's just look at this on the coronal reconstructions.

1:48

Here you can see it basically straddling the midline

1:51

with benign remodeling of the medial walls

1:56

of the maxillary antrum, which is typical of a low grade

2:01

chondro sarcoma.