Sinonasal schwannoma (SNS) is a rare entity with 4% occurring at this location and only 36 cases described in the literature. A 22-year-old woman presented recurrent unilateral epistaxis, hyposmia, unilateral nasal obstruction, and hemicranial headache for a year. The endoscopic examination showed a tissue mass filling the left nasal cavity and nasopharynx. Imaging showed a mass that occupied the left posterior ethmoid cells in the hyposignal T1, hyposignal T2, and gadolinium enhancing. A preoperative biopsy was made and the diagnosis was a schwannoma. The tumor mass was completely removed under general anesthesia. The final histopathological study reconfirmed the diagnosis of schwannoma. Six months after surgery, control endoscopic and imaging showed the absence of tumor recurrence. SNS is a rare entity and its diagnosis is generally based on a histological examination. Therefore, the possibility of schwannoma must be considered in front of a mass of the nasal fossa.

Tumors in the nasal septum originating from salivary glands are uncommon, and among them, pleomorphic adenomas represent a distinctive manifestation.This case study explores a female in her early thirties with a right-sided nasal mass, nasal obstruction, and intermittent bleeding. CT imaging revealed a lesion arising from the nasal septum with bony erosion. Histopathology confirmed pleomorphic adenoma,emphasizing the importance of thorough clinical evaluation, imaging, and biopsy for accurate diagnosis. Pleomorphic adenomas, typically found in major salivary glands, can occur in the respiratory tract, presenting challenges in distinguishing them from malignant tumors. Treatment involves wide local resection, and postoperative recurrence may necessitate radiotherapy. While intranasal pleomorphic adenomas generally have a favorable prognosis, those arising from the nasal septum have an elevated likelihood of malignancy. Vigilant monitoring is crucial due to the potential for recurrence, malignant transformation, and metastasis.

BACKGROUND: Nasal rhinosporidiosis refers to a rare chronic granulomatous disease caused by Rhinosporidium seeberi. It affects the mucous membrane of sites such as nasopharynx, conjunctiva and palate. Inverted papillomas are relatively rare and are benign epithelial tumors of the nasal cavity that are locally aggressive, exhibit recurrence tendency and malignant transformation. Both entities are very rare in our setting and this is perhaps the first documented case in Tanzania.
METHODS: The patient was a 7-year old boy with a 1-year history of left-sided nasal obstruction and intermittent epistaxis for 6 months. He had no history of cheek swelling, pain or numbness, loss or loosening of teeth or alveolar ridge fullness. There were no ophthalmological, otological or neurological complaints reported. Endoscopic excision of the nasal mass was done and histopathological analysis confirmed co-existence of rhinosporidiosis and inverted papilloma. Postoperatively, the patient was kept on oral dapsone at a dose of 50 mg/day for 6-months and with no residual disease recurrence noted after 6-months follow up.
UNASSIGNED: The patient underwent endoscopic excision of the nasal mass and histopathological analysis confirmed co-existence of rhinosporidiosis and inverted papilloma. Postoperatively, the patient was kept on oral dapsone at a dose of 50 mg/day for 6-months and with no residual disease recurrence noted after 6-months of follow up.
CONCLUSIONS: Nasal rhinosporidiosis and inverted papilloma lesions may resemble the routinely encountered nasal polyps thus important for both clinicians and pathologists to have a high index of suspicion when managing patients with nasal masses even from non-endemic areas.

Rhinosporidiosis is a granulomatous disease commonly affecting the mucous membrane. It is caused by Rhinosporidium seeberi, an aquatic parasite & seen affecting the nose, paranasal sinuses most commonly. A retrospective study was conducted at a tertiary care hospital situated in Indian peninsula and five patients who were diagnosed and treated for rhinosporidiosis were analysed. Surgical excision by coblator along with medical management using Dapsone 100 mg once daily for 6 months given promising results in view of reducing recurrence. Combined approach of management including surgical excision using coblator and medical therapy with dapsone is effective in managing the rhinosporidiosis with no recurrence.

We report two cases of nasal alveolar rhabdomyosarcoma (ARMS) in adult patients from our center who presented with local mass effect and systemic involvement. Our first patient had spontaneous unilateral epistaxis. Her blood investigation showed severe thrombocytopenia, and the bone marrow biopsy result showed bone marrow infiltration by non-hematopoietic malignant cells. Nasal endoscopy showed a mass arising medial to the left middle turbinate. Our second patient presented with right eye proptosis, associated with blurring of vision. Nasal endoscopy showed a right whitish nasal mass arising lateral to the middle turbinate. Both patients were diagnosed by immunohistochemical analysis showing ARMS, a soft tissue malignancy uncommon in adults. RMS in adults has a worse prognosis. Hence, the management is challenging. Early diagnostic workup is essential for the commencement of early treatment for better oncological outcomes.

UNASSIGNED: We present a case of a fourteen year old girl who presented with a large intra-nasal mass to the ENT team at a district general hospital in the UK.
UNASSIGNED: The girl presented predominantly with nasal obstruction and some symptoms of allergic rhinitis. Imaging revealed a large lesion abutting the skull base and causing bony remodelling with marked septal deviation. Based both on CT and MRI imaging, the reporting (non-head and neck) radiologist suggested inverted papilloma as a differential diagnosis. Intra-operative exploration in fact revealed a very large left middle turbinate mucocele extending to the left frontal sinus. The mass was excised endoscopically without complications.
UNASSIGNED: Although concha bullosa of the middle turbinate of the nose are common, development of a mucocele within them is far less common and for such a mucocele to develop to this size in a child is extremely rare. The egg shell lining of the lesion can be a tell-tale sign of their aetiology when taken alongside other radiological factors. This case highlights challenges in radiological diagnosis of intra-nasal masses in children, which can lead to delays and increased anxiety.
UNASSIGNED: When assessing nasal masses in children it is important to keep a wide differential due to the challenges of diagnosis. A close conversation should be had with local head and neck radiologists and, of course, where there is a unilateral nasal mass tissue sampling is essential and may be taken as part of a full excision where clinically indicated.

Inverted sinonasal papillomas, also referred to as Schneiderian papillomas, are benign tumors originating from the Schneiderian membrane that lines the nasal cavity and paranasal sinuses. They frequently display an endophytic growth pattern, in which the stroma beneath is invaded by epithelial cells. The exact cause of inverted sinonasal papillomas is unknown, but several theories have been offered. The most widely accepted theory states that these tumours arise from the metaplasia of the respiratory epithelium into a stratified squamous epithelium. This metaplastic process is thought to be brought on by irritant exposure, chronic inflammation, or viral infections like the human papillomavirus (HPV). While inverted sinonasal papillomas commonly arise from the paranasal sinuses and lateral walls of the nasal cavity, their occurrence from the nasal septum is relatively rare. Additionally, although inverted sinonasal papillomas are typically benign, they can exhibit locally aggressive behaviour and damage nearby structures. The histopathological examination revealed nuclear atypia, which raises questions about the potential for malignant transformation. We describe a rare case of an inverted sinonasal papilloma that developed from the nasal septum. The tumour spread into the septum\'s anterior cartilaginous region, causing the cartilage to deteriorate and develop mucosal defects. The rarity of an inverted sinonasal papilloma arising from the nasal septum along with its impact on cartilaginous septum is discussed. Careful monitoring and prolonged follow-up are therefore necessary to spot any signs of recurrence or malignant changes.

Nasal dermoid cyst is a rare benign lesion. The mainstay of treatment for a nasal dermoid cyst is surgical excision, which aims to remove the cyst and associated structures to prevent recurrence. We report a case of a 30-year-old man with nasal dermoid cyst, without intranasal or intracranial extension. The patient underwent open rhinoplasty technique for dermoid cyst excision. He had an uneventful postoperative recovery and was discharged well. The cyst and associated structure were successfully removed. There was no evidence of recurrence and complications postoperatively after 2 years of follow-up.

Foreign body insertion inside the nose is not uncommon in pediatric age groups. It can pass unnoticed by parents, sometimes underdiagnosed or incompletely removed by a clinician. In another scenario, it may be incidentally discovered by imaging during dental workups commonly. This foreign body acts like a nidus for a rhinolith, as it gets calcified over years and becomes like a stone, causing unilateral nasal symptoms. Herein, we present a case of a young female with a rhinolith mistaken for fungal mud. We aim to emphasize this rare clinical condition that, if left unperceived, may lead to complications including, but not limited to, sinusitis, pressure necrosis to the surrounding structure causing septal perforation, or naso-palatal fistula.

Pituitary macroadenoma and angiofibroma are two distinct and diverse types of tumors that can develop in different anatomical locations and clinical characteristics and are not typically related to each other in terms of their hormonal or developmental aspects. This case describes an adult male with pituitary macroadenoma with nasal angiofibroma. A 35-year-old male was diagnosed with pituitary macroadenoma and incidentally found to have juvenile nasopharyngeal angiofibroma (NPA). The patient underwent a diagnostic workup, including imaging studies and hormonal assays, which confirmed the concomitant presence of both tumors. The patient underwent successful endoscopic surgical excision of the NPA and transnasal transsphenoidal endoscopic pituitary macroadenoma excision as a two-stage operation. The patient was followed up postoperatively and had no evidence of tumor recurrence or hormonal imbalances. The importance of complete and comprehensive diagnostic workup and multidisciplinary management in achieving successful and optimum treatment outcomes for coexisting NPA and pituitary macroadenoma in an adult patient is highlighted in the present report.