Intended for healthcare professionals

Endgames Case Review

A calcified mass in the nose

BMJ 2022; 379 doi: https://doi.org/10.1136/bmj-2021-068735 (Published 02 November 2022) Cite this as: BMJ 2022;379:e068735
  1. Hao Meng Yip, core trainee,
  2. Declan Costello, consultant,
  3. Roland Hettige, consultant
  1. Ear, Nose, and Throat department, Wexham Park Hospital, Slough, UK
  1. Correspondence to: H M Yip meng.yip{at}nhs.net

A woman in her 40s presented with a five year history of recurrent left nasal discharge, bleeding, and obstruction. Her symptoms had not improved with use of nasal sprays, including those with steroids. She reported no history of nasal trauma, foreign body insertion, or underlying allergy. She was otherwise healthy.

Questions

  1. What are the malignant differential diagnoses of unilateral nasal symptoms?

  2. What are the non-malignant differential diagnoses of unilateral nasal symptoms?

  3. What further investigations are required for unilateral nasal symptoms?

Answers

1. What are the malignant differential diagnoses of unilateral nasal symptoms?

Although malignant causes such as chondrosarcoma and osteosarcoma are rare, maintain an index of suspicion. Any persistent (lasting for 3-4 weeks) unilateral nasal obstruction with discharge …

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