case_images: PMC11782827_01
case_images: (A) CT scan post contrast with sagittal view in soft tissue reconstruction shows the soft tissue mass (arrow) in right ITF with heterogeneous low density and faint peripheral calcifications. (B) CT scan with sagittal view in bone algorithm reconstruction shows the sclerosis of the temporal bone with erosion of the outer cortex (arrow).
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case_images: The patient's computed tomography (CT) scan of paranasal sinuses showed heterogeneous mass in the right ITF with soft tissue density and thin peripheral rim of calcifications (Fig. 1A). It results in sclerosis and erosion of the outer cortex of the bones (Fig. 1B).
case_images: (A) MRI with transaxial T2 view shows the ITF mass with predominant hypointense signal and scattered hyperintense small foci displacing the right masticator space anteriorly up to the posterior wall of the right maxillary antrum. (B) Pre and post contrast axial T1 image shows heterogeneous signal intensity with inherent bright spots and no post contrast enhancement.
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case_images: T1 and T2 with no enhancing soft tissue component (Fig. 2A, B). The mass displaces the lateral pterygoid muscle anteroinferiorly and the parapharyngeal space posteromedially with no intracranial extension or dural involvement.
case_images: CT-guided percutaneous true-cut biopsy of the right ITF mass.
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case_images: The patient underwent a CT-guided biopsy (Fig. 3), which showed clusters of osteoclasts type giant cells with many mononuclear background cells and foamy histiocytes, some of which are hemosiderin laden.
case_images: Tumor exposure after removal of posterior maxillary sinus wall (arrow).
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case_images: Therefore, the patient underwent endonasal endoscopic trans-maxillary removal of ITF lesion which was performed by an experienced surgeon specialized in rhinology and skull base surgery, the bony posterior wall of the right maxillary sinus was dissected and removed with right ear ventilation tube insertion, as seen in Fig. 4 and Fig. 5.