Mucocele of a giant inferior turbinate concha bullosa mimics a nasal mass: case report

Abstract

Abstract Background The concha bullosa is a pneumatized nasal turbinate commonly middle turbinate but that of the inferior turbinate is an uncommon entity. A giant inferior conchal pneumatization with mucocele formation is not reported in the literature till now. Case presentation A 17-year-old female patient presented with bilateral severe nasal obstruction. Anterior rhinoscopy and endoscopic examination revealed a giant mass which filled the left nasal cavity completely, pushing the septum to the contralateral side. The paranasal sinus CT showed a mass in the left nasal cavity ballooning the whole nasal cavity with compression of the nasal septum to the right side. MRI was done and the lesion was hyperintense in T2 MRI sequences and hypointense in T1 sequences consistent with a cystic lesion. The patient was consented and prepared for endoscopic resection under general anesthesia. The lesion was completely separated from the nasal septum and the orbit but attached to the lateral nasal wall at the site of origin of the inferior turbinate. Conchoplasty was done and patient follow-up for 9 years is excellent with complete disappearance of all patient symptoms. Conclusions Concha bullosa of the inferior turbinate should be considered in the differential diagnosis of nasal tumors, nasal cystic lesions, and preoperative evaluation of endoscopic sinus surgery. Also, a systematic approach for dealing with nasal lesions with thorough examination and radiological review will be of great value in decision-making. The anatomy of the paranasal should be thoroughly examined prior to endoscopic sinus surgery to develop treatment strategies and to prevent possible complications.