Pediatric nasal cavity masses

Pediatric nasal cavity masses can occur within the nose or the nasopharynx. These masses are often found incidentally on imaging but can be readily apparent clinically.

Clinical presentation

The clinical features of these lesions tend to mimic upper respiratory processes and may result in delayed diagnosis due to this. As symptoms are often non-specific, imaging is usually required to evaluate these lesions.

Pathology

Lesions can arise from structures of the nose, nasopharyngeal mucosa, or adjacent anatomical structures. There is a wide range of underlying conditions that can result in pediatric nasal cavity masses, and these can largely be grouped into non-neoplastic and neoplastic disorders:

• non-neoplastic disorders
  • congenital and developmental
    • congenital nasolacrimal duct mucocele
    • nasal midline masses
    • chondromesenchymal hamartoma (rare)
  • infectious and inflammatory
    • cysts
    • polyps
    • nasal septal abscess
  • vascular: nasal pyogenic granuloma
  • trauma: septal hematoma
  • foreign body
• neoplastic disorders
  • benign neoplasms
    • infantile hemangioma
    • juvenile nasopharyngeal angiofibroma
    • giant cell tumor
    • nasal pleomorphic adenoma
    • aneurysmal bone cyst
    • fibro-osseous lesions
  • malignant neoplasms
    • rhabdomyosarcoma
    • leukemia, lymphoma
    • nasopharyngeal carcinoma
    • metastatic disease: neuroblastoma
    • esthesioneuroblastoma

Radiographic features

CT and MRI are important in characterizing these lesions. MRI is the modality of choice in the pediatric population, but sometimes CT is necessary to assess bony involvement.