0:00

This is an unfortunate patient, which as

0:02

you can see, had congenital deformities

0:05

and also some mental retardation and

0:09

cerebral palsy, as if that wasn't enough.

0:12

Unfortunately, as you can see, the patient has a mass

0:15

that is seen growing in the maxillary

0:17

sinus as well as the left nasal cavity.

0:20

I don't know why all these tumors seem to be growing

0:22

on the left side, but in any case, as you can

0:26

see, heterogeneous signal intensity to this mass.

0:29

On the T2-weighted scan, we have

0:31

cystic areas as well as solid areas.

0:34

You can see the intracranial

0:36

growth, but once again, it's not growing into the

0:40

brain parenchyma, although it's displacing the

0:42

frontal sinus, uh, I'm sorry, the frontal lobe.

0:45

And you can see that there is

0:46

some dural-based enhancement.

0:48

This was an undifferentiated sarcoma.

0:51

Just to show you that all of these have

0:54

this heterogeneous signal intensity.

0:56

Again, would someone call this cerebriform

0:59

and call this an inverted papilloma?

1:01

Possibly. Again,

1:03

easy to get a diagnosis.

1:05

You go in with an endoscope.

1:08

You're right here by the inferior

1:09

turbinate, you get a piece of the tissue.

1:11

It's not really that important for

1:13

us as neuroradiologists to suggest a

1:15

diagnosis when they're gonna be able to

1:17

catch a piece of the tissue right here.

1:19

They wanna make sure that this is not

1:21

brain tissue and this is not encephalocele.

1:23

They wanna make sure that this is not a

1:25

juvenile nasopharyngeal angiofibroma that

1:27

might bleed like hell after the biopsy.

1:30

So that's what, what our role is,

1:32

as well as to say to them, there's

1:35

involvement here in the extraconal orbit.

1:37

It looks like the medial rectus muscle might

1:41

be involved as well as the intraconal space.

1:44

And therefore there's a chance that once you

1:46

get in there, you may be taking the orbit.

1:49

You can see the displacement of the globes here,

1:52

the involvement of the soft tissues in the lacrimal

1:55

sac region, the intracranial involvement, but

1:59

the absence of infiltration of the brain

2:02

tissue.In this case, an undifferentiated

2:05

sarcoma of the sinonasal cavity.