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Case of the Month – January

By Dr Mahomed Seedat

History:

56 year old female patient presented to her Doctor with a history of a blocked left nostril for two years.

Imaging:

MRI Brain

Findings:

MRI of brain showed lesion of the left posterior choana is centred on the sphenopalatine foramen and involves the left pterygopalatine fossa as well as the post nasal space. There is some bone covering this lesion on the CT indicating that it has grown from the pterygopalatine fossa through the sphenopalatine foramen into the post nasal space. The lesion is T1 iso-intense measuring 28x27x31mm, T2 hyperintense and enhances homogeneously with a central low signal “scar”.

Conclusion:

This lesion is likely to represent a Schwannoma of the ascending palatine nerve. This involves the post nasal space, the pterygopalatine fossa and the sphenopalatine foramen.

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