Subhadeep Chowdhury1, Tithi Debnath2
A 28-year-old female patient presented at ENT OPD with complaints of a slowly
growing mass over nasal tip since last 5 years. There were no complaints of pain,
nasal obstruction, or epistaxis. There were no skin changes or ulceration over the
swelling and sensation was preserved. There was no history of similar kind of
swelling in other parts of the body. History of trauma or any form of surgical
intervention were excluded. Family history was insignificant. The swelling did not
respond to any medications. The patient attended for cosmetic reason solely.
Clinical examination showed a soft non-tender 4 cm by 4 cm mass over nasal tip
and supratip area. Mobility of the mass was restricted and fixed to the alar
cartilages. There was no evidence of café au lait spots or any other skin lesions.
Anterior rhinoscopy was unremarkable. Diagnostic nasal endoscopy was also
performed but no abnormality was detected. CT scan showed non-specific
infiltrative subcutaneous lesions. T1W MRI showed an ill-defined hypodense mass
over the nasal tip which was abutting the alar cartilages which showed mild
enhancement with contrast (figure 1). T2W MRI showed hyperintense and or
hypodense central focus (target sign). FNAC was done and report was suggestive
of neurogenic tumour, most probably neurofibroma.
