Clinicopathologic and radiologic features of pediatric unilateral nasal masses at a tertiary hospital

Eman R. Alanazi, Ali A. Almomen, Hadeel M. Aljafer, Ghaleb M. Alazzeh, Abdurahamn M. Alkhatib


Background: Cases of unilateral nasal masses (UNM’s) are usually inflammatory but some are neoplastic in nature.  We conducted this study to determine the clinic-pathologic features, radiological findings and patterns of UNM’s in our institution.

Methods: We conducted a retroactive chart review of all pediatric cases followed and treated for medically untreatable UNM from 2015 till 2018 at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia.  

Results: Cases of 25 patients (16 males and 9 females) with a mean age of 10.81±4.53 years were studied. There were 12 patients (48.0%) who presented with a nasal obstruction, and nasal polyp was found by fiberoptic nasal endoscopy (FNE) in 12 patients (48.0%). Two patients (8.0%) had unremarkable FNE findings. The most common site of origin of the mass was the ethmoid sinus (24.0%). Twenty patients (80.0%) had FESS, 3 (12.0%) had endoscopic excision, 1 had FESS plus abscess drainage and 1 (4.0%) had marsupialization. Two patients (8.0%) had recurrence 12 months after surgery, and one patient (4.0%) had recurrence six months after surgery. Six patients (24.0%) had malignant tumor of which 3 patients (12.0%) expired from the disease.

Conclusions: Pediatric patients with a UNM may present with varied symptoms and may show unremarkable results with nasal endoscopy. However the risk of having an underlying malignant process is very high, thus a histopathologic diagnosis is warranted to confirm the diagnosis.



Clinical, Nasal masses, Pathological, Pediatric, Radiological

Full Text:



Pradhananga RB, Thapa PA, Shrestha A, Pradhan B. Overview of nasal masses. J Inst Med. 2009;31(1).

Habesoglu TE, Habesoglu M, Surmeli M, Uresin T, Egeli E. Unilateral sinonasal symptoms. J Craniofac Surg. 2010;21(6):2019-22.

Pauna HF, Carvalho GM, Guimarães AC, Maunsell RC, Sakano E. Schwannoma of the nasal septum: evaluation of unilateral nasal mass. Brazil J Otorhinolaryngol. 2013;79(3):403.

Jackson LE, Rosenberg SI. Pleomorphic adenoma of the lateral nasal wall. Otolaryngol Head Neck Surg. 2002;127(5):474-6.

Mackle T, Zahirovic A, Walsh M. Pleomorphic adenoma of the nasal septum. Ann Otol Rhinol Laryngol. 2004;113(3):210-1.

Tritt S, McMains KC, Kountakis SE. Unilateral nasal polyposis: clinical presentation and pathology. Am J Otolaryngol. 2008;29(4):230-2.

Benoit MM, Bhattacharyya N, Faquin W, Cunningham M. Cancer of the nasal cavity in the pediatric population. Pediatrics. 2008;121(1):141-5.

Yaman H, Alkan N, Yilmaz S, Koc S, Belada A. Is routine histopathological analysis of nasal polyposis specimens necessary? Eur Arch Oto-Rhino-Laryngol. 2011;268(7):1013-5.

Nair S, James E, Awasthi S, Nambiar S, Goyal S. A review of the clinicopathological and radiological features of unilateral nasal mass. Indian J Otolaryngol Head Neck Surg. 2013;65(2):199-204.

Keck T, Liener K, Sträter J, Rozsasi A. Rhinolith of the nasal septum. International J Pediatr Otorhinolaryngol. 2000;53(3):225-8.

Adil E, Huntley C, Choudhary A, Carr M. Congenital nasal obstruction: clinical and radiologic review. European J Pediatr. 2012;171(4):641-50.

Özcan C, Apa DD, Görür K. Pediatric lobular capillary hemangioma of the nasal cavity. Eur Arch Oto-Rhino-Laryngol Head Neck. 2004;261(8):449-51.

Van der Lee JH, Wesseling J, Tanck MW, Offringa M. Efficient ways exist to obtain the optimal sample size in clinical trials in rare diseases. J Clin Epidemiol. 2008;61(4):324-30.

Rodriguez DP, Orscheln ES, Koch BL. Masses of the nose, nasal cavity, and nasopharynx in children. Radiographics. 2017;37(6):1704-30.

Belli S, Yildirim M, Eroglu S, Emre FK. Single-sided sinonasal mass: A retrospective study. Northern Clin Istanbul. 2018;5(2):139.

Di Rocco F, Couloigner V, Dastoli P, Sainte-Rose C, Zerah M, Roger G. Treatment of anterior skull base defects by a transnasal endoscopic approach in children. J Neurosurg Pediatr. 2010;6(5):459-63.