RESUMO
Cocaine abuse is associated with medical complications that depends on the route of administration. Intranasal [quot] snorting [quot] is associated with complications secondary to chronic irritation on the nasal mucosa. A case of long-standing intranasal cocaine abuse is presented with unusual complications: septal and palatal necrosis, osteolytic sinusitis and bilateral optic neuropathy. The CT scan demonstrated a soft-tissue mass in etmoid and sphenoidal sinus and orbits. The histopathologic examination revealed a nonspecific pattern of chronic inflammation with no evidence suggestive of infection, neoplasm or lethal midline granuloma. The case had a fatal outcome. Because of the constellation of singular manifestations we discuss the differential diagnosis. Interdisciplinary approach is stressed. Emphasis is made in early diagnosis