A case of extranasopharyngeal angiofibroma of the ethmoid sinus: a distinct clinical entity at an unusual site.

Angiofibromas of the head and neck usually arise from the nasopharynx in adolescent boys. The term extranasopharyngeal angiofibroma (ENA) has been applied to vascular fibrous nodules that arise outside the nasopharynx. Because the clinical characteristics of ENA are not consistent with those of juvenile nasopharyngeal angiofibroma (JNA), diagnosis of the former can be challenging. Biopsy is ill advised in a patient with an ENA because it might result in brisk bleeding. A high index of suspicion and a methodical evaluation are essential in establishing the proper diagnosis and treatment. We report the rare case of a 16-year-old girl who presented with a pinkish lobulated mass in her left nostril that had arisen from the anterior ethmoid sinus. The mass was removed via a lateral rhinotomy approach. Postoperative histopathologic analysis identified it as an angiofibroma. To best of our knowledge, only 9 cases of ENA arising from the ethmoid sinus have been previously reported in the English-language literature.

Sinus histiocytosis with massive lymphadenopathy.

Sinus Histiocytosis with Massive Lymphadenopathy is a very rare condition often presenting as neck swelling of unknown etiology. The disease involves extranodal sites in 20-30 percent of cases and histologically characterized by emperiopolesis, non-cohesive and non-epitheloid histocytes with abundant eosinphilic cytoplasm. An ideal treatment is yet to be established but here we present a short series of chemotherapy with alternating ABVD and COPD cycles giving satisfactory results.

Unusual presentations of foreign body in aerodigestive tract.

Foreign bodies lodged in aerodigestive tract makes the commonest emergency in the otorhinolaryngology clinics. Diagnosis often becomes difficult with parental ignorance and lack of clear history. Patients with foreign body can have unusual presentations.