0:01

Here we have a patient who was being evaluated

0:03

with a seizure disorder and had an incidental

0:07

finding noted in the left nasal cavity.

0:10

So the T2-weighted scans were being scanned,

0:12

were being looked at for the brain abnormality,

0:17

and at the lower portion of the study,

0:21

someone discovered a mass that was seen in the

0:24

nasal cavity just in the nasal ala here.

0:27

On the left side,

0:29

this is the flare scan and

0:33

this subsequently was imaged with

0:37

higher resolution imaging,

0:39

as you can see on the T1-weighted imaging.

0:41

On the coronal T2-weighted scan, again, performed for

0:45

the brain. If you look anteriorly here,

0:48

you can see that there is a mass in the left nasal

0:52

cavity, which is bright in signal intensity

0:59

outlined here,

1:02

and it seemed to be associated with,

1:05

this is the inferior nasal turbinate,

1:07

maybe more centered at the

1:10

middle turbinate region.

1:12

And this lesion on the subsequent images, as you

1:15

can see, came out pretty far anteriorly,

1:20

so that it was actually visible just looking

1:22

into the patient's nose via the nasal ala.

1:26

Bright in signal intensity on T2-weighted imaging.

1:29

When we look at the lesion

1:30

on T1-weighted scans,

1:31

we have a little better sense of the anatomy with

1:33

the lateral wall of the nasal cavity being

1:36

displaced laterally with it opposed to the

1:40

cartilaginous nasal septum, and being

1:44

relatively well-defined.

1:46

Here it is associated with the turbinate.

1:49

On the post-gadolinium-enhanced scan,

1:54

you see that the lesion has a little

1:56

bit of internal architecture to it,

1:58

but it is well defined.

1:59

Doesn't look like it's invading the bone.

2:01

This is your lower aspect of your nasolacrimal duct.

2:06

Here's the nasal turbinate. So, really, in the nasal cavity.

2:10

And in point of fact,

2:13

this turned out to be a pleomorphic adenoma.

2:16

The features which would suggest a pleomorphic

2:18

adenoma are the very bright signal intensity on

2:21

T2-weighted imaging, as well as the well-defined

2:23

nature of it and the in contrast enhancement.

2:27

Here's the coronal contrast-enhanced image.

2:30

And once again, you might suggest that there is

2:33

increasing enhancement over the course of time on

2:36

the MRI scan in the mass with portions that show

2:40

greater enhancement on the delayed imaging, which

2:43

is another feature of the pleomorphic adenoma.

2:47

Now, we did have,

2:48

I believe we had diffusion weighted

2:50

imaging of the brain and it's kind

2:56

of hard to make out here.

3:00

But this lesion was bright on the DWI and the

3:05

ADC map, suggesting a benign etiology.