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Squamous cell carcinoma of the maxilla

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Large right sided facial mass for one year. Only attended hospital when no longer able to chew.

Patient Data

Age: 70 years
Gender: Male

CT FACIAL BONES

Huge right facial mass centered on the right malar region with bulk dimensions of 8 x 6.8 cm.

The mass extends into and occupies the entirety of the right maxilla through the osteomeatal complex into the right ethmoidal air cells. The right frontal sinus is partially opacified which may represent tumor or obstructive fluid. No extension across the midline.

A 2 cm component of the mass extends into the right masticator space. Irregularity and sclerosis of the right pterygoid plate. Sclerosis of the right frontal bone, without destruction of the inner table of the skull.

Some of the right upper dentition is floating.

Several right level Ib nodes up to 1 cm. Single 8mm level II node.

Huge right facial mass centered on the right malar region with dimensions of 8 x 6.8 cm.

The mass extends into and occupies the entirety of the right maxilla through the osteomeatal complex, with obstructive fluid in the right maxillary, ethmoidal and frontal sinuses. No tumor extension beyond the right middle turbinate.

A 2 cm component of the mass extends into the right masticator space. The mass is abutting the origin of the right pterygoid muscles.

The tumor only crosses the midline within the buccal cavity lying on the dorsal aspect of the tongue.

Several right level Ib nodes up to 1cm. Single 8mm level II node.

Case Discussion

Huge right maxillary tumor with paranasal and masticator space extension and associated lymphadenopathy.

A decent case for learning the anatomical spaces of the neck.

BIOPSY:  Poorly differentiated squamous cell carcinoma

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