Nasal Rhinosporidiosis
with septal perforation a unique case report
By
Dr. T. Balasubramanian
M.S. D.L.O.
Synonyms: Nasal rhinosporidiosis
with septal perforation
Case
Report: 30 Years old male patient came
to me with h/o
1. Bleeding from both nasal cavities on and
off for 10 years
2. Blocking sensation in left nasal cavity
for 10 years
3. Headache on and off on the left side -
7 years
4. Foul smelling nasal discharge from left nose - 5
years
He also gave history of taking bath in ponds.
On
examination: Left nasal cavity was found filled with a friable
leaf like mass. Mass was found occupying the floor of the left
nasal cavity extending up to the choana. Mass was seen
protruding out of choana into the nasopharynx. The mass was
friable and started to bleed on touch. A perforation was seen
on the cartilagenous portion of the nasal septum through which the
mass extended in to the right nasal
cavity. Clinically the mass
resembled a rhinosporidial mass.
CT scan taken
showed:
This
coronal Scan shows perforation in the anterior cartilagenous portion
of nasal septum
This coronal scan shows mass passing
through the eroded septum
Discussion:
Till date no case of nasal rhinosporidiosis has been reported with
septal perforation. In this patient the cartilagenous portion
of the septum was found to be eroded. In fact it is the
cartilage which is supposed to be more resisitant to tumor
invasion.
The possible causes of septal erosion in
this patient could be:
1. Rhinosporidial mass causing
repeated infection of the perichondrium of nasal septal cartilage
leading on to chronic perichondritis and septal erosion.
2.
Pressure effects of the mass - (Not acceptable taking into
consideration the benign nature of the lesion and its
size).
The mass was excised totally. Biopsy was
reported as rhinosporidiosis.
This
picture shows the perforated
septum
Here you will be seeing the surgical clipping of the patient
