Case reportA rhinolith which is mimicking a nasal benign tumor
Introduction
A rhinolith is a mineralized mass resulting from calcification of an endogenous or exogenous nidus within the nasal cavity [1]. The mineralization is generally secondary to an object which has become lodged in the nasal cavity [1].
Appleton et al. [1], stated that more than 600 cases had been reported in the literature since 1654. Since 1988, the total of cases which have been reported is 12 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, so that it is apparent that rhinoliths are quite uncommon.
Most of the patients with rhinolith could not remember the entrance of a foreign body. However, diagnosis is made upon a history of nasal obstruction, discharge, odor or pain and the rhinoliths are frequently visualized as nasal stones during intranasal examination [1]. Radiological examinations, especially CT helps in differential diagnosis and it also demonstrates the complications of the rhinolith 9, 15.
Section snippets
Case report
A 10-year-old boy with nasal obstruction and intermittent nasal bleeding was admitted as an outpatient by the Pediatric Department. He had fallen on the beach and injured his nose, 5 years previously. He said that some sand had entered his nose at that time. The pediatrician detected a mass in the nasal cavity and X-ray showed an opacity on the floor of the nasal cavity (Fig. 1). He requested a CT examination for differential diagnosis of a soft tissue tumor.
The CT examination showed a
Discussion
Rhinolithiasis is caused by complete or partial encrustation of intranasal foreign bodies. Most of them are exogenous such as beads, buttons, pieces of paper, cherry pits, stones, pebbles, sand, fruits, peas, parasites, wood or glass. Endogenous agents may also cause rhinoliths. These include sequestra, dried pus, desquamated epithelium, clotted blood, leukocytes, bone fragments or teeth 16, 17, 18. In this case, a foreign body was not found, but because of his history, we thought that it might
References (19)
- et al.
Rhinolithiasis: A review
Oral Surg Oral Med Pathol
(1988) Rhinolith: an unusual cause of palatal perforation
Br J Oral Maxillofac Surg
(1988)The septal translocation procedure: an alternative to lateral rhinotomy
Otolaryngol Head Neck Surg
(1988)- et al.
Nasal regurgitation as the presenting symptom of rhinolithiasis
J Laryngol Otol
(1988) Rhinolith—its occurrence and dental implications
Tandlakartidningen
(1988)Rhinolithiasis complicated by purulent dacryocystitis
Med Pregl
(1989)- et al.
Nasolith removal with ultrasound lithotripsy
HNO
(1991) A rhinolith with a nucleus from the remains of a gauzetampon
Vestn Otorinolaringol
(1992)- et al.
Posttraumatic rhinolith
Am J Neuroradiol
(1993)