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Sinus Tumor
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jacigia posted:
Hello, I recently have been diagnosed with a tumor in my sinus area. My CT reports the following:

"There is a soft tissue density mas measuring 2.1x1.7x1.7 cm which extends from the base of the nasal cavity in the midline and creates marked remodeling of the anterior maxilla with smooth rounded edges without evidence of aggressive bony destruction. This extends to the level of the dentition. A portion of the nasal septum is also involved or destroyed. Effacement of the inferior nasal turbinates are also appreciated."

I've always had a hard time breathing and always had alot of mucus in my nose, I just thought it was normal. Lately I can feel alot of pressure coming down to my front teeth just by wiping my nose. Now my front teeth are very sensitive when I touch them or eat.

When the Dr's performed a scope they notice "bump" that can explain the blockage of air when I breath. I have done one biopsy that concluded to be negative of maglinancy but because the biopsy was done through the pallet, I have been recommended for another biopsy through the nose. Based on the information I provided, would you know how the tumor can be removed? At this point I have seen a few Dr's and they will not provide me an answer until further test can be done. Also what are the chances that this can be malignant? My biopsy is next week and I cannot stop worrying about the situation and wondering if I will be permanently disfigured by having the tumor removed. I am in alot of pain and constantly have been on pain killers for the last few weeks. Any advice or suggestion will be helpful. Thanks.
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Rod_Moser_PA_PhD responded:
No, I am sorry, but it is not possible for me to know if your tumor can be removed based solely on the information in the CT scan. That will be up to the skill and comfort level of the surgeon. And, unfortunately, one can only determine conclusively if a lesion or mass is malignant after the full pathology report. If your doctor felt that this mass was cancerous, I am sure you would be having some other imaging studies or consultations. It is the word "tumor" that frightens people, but most tumors/growths are not cancerous.

Most ENT surgeons are very skilled plastic surgeons. I am sure that all efforts will be made to prevent any disfigurement. A mass this small...in the sinuses....should not result in any outward evidence that you even had a surgery.
 
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jacigia responded:
Thanks for the reply Dr. Moser.

That's alot of relief. I will be having my another biopsy next wednesday so we'll see what exactly it really is. Thanks again.
 
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Rod_Moser_PA_PhD responded:
Please let me know how things turn out....
 
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jacigia responded:
Hello Dr. Moser,

Last time I wrote in I was concerned about the type of tumor that I was diagnosed with. Results from the latest biopsy show that I have a benign Inflammatory Myofibroblastic Tumor in my nasal floor. The tumor as has eaten through the maxilla and a part of my nasal septum. I have seen two doctors so far regarding my condition and both have recommended that my palate be removed along with about 8 of my upper teeth. I am very hesitant about the procedure and still looking for someone that may help me w/o such drastic measures. Regarding the pain, since my biopsy was done the ENT Dr, has told me that there was alot of fluid that was drained out of the tumor and now I do not feel the pressure that I had experienced before, now I just feel a dull pain from my palate inside my mouth. I do not know where to turn to and doctors are telling me that this type of tumor is very rare and even rarer to be in the maxilla area. If you can please give me some directions or know how to where I might find some help that would be great. If you need anymore information regarding my case please let me know, I have all the reports with me. The biggest fear that I have regarding the treatment that have been suggested so far is the removal of so many of my teeth, I am only 31 and the thought of having to wear dentures is not pleasant for me. I am owning up to the fact that this maybe the only option I have but my scheduled surgery is on 8/20/09 and I am trying to find out more options that I may have because once I go through with the surgery I will never get my teeth back. Please help. Thanks.
 
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Rod_Moser_PA_PhD responded:
I can certainly appreciate your anxiety about this surgery, but you may not have any options. It appears that this tumor is invasive and destructive, so it needs to come out of there. If you have to sacrifice some teeth in order to do this, then this may be what you have to do. Personally, I have no experience in dealing with this type of tumor, so I cannot really offer you any profound insight. You can get a second opinion from another ENT -- someone that can examine you and review your imaging studies -- but I suspect you may get the same recommendation.

The surgeons that do this type of surgery are experts -- they are GOOD, and I am sure that will do their very best to limit the collateral damages. My heart truly goes out to you, and I hope you will post about your experiences.
 
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pokegai responded:
Hello Dr. Moser,

I just wanted to update you on my situation. Since the last time we spoke, I was planning to go in for a maxillectomy but the week before my scheduled surgery my Dr called me and told me that their pathologist could not agree on the diagnose after they looked at my slides. He recommended that a surgery should be planned to remove just the mass and have the pathologist take another look at it to determine what exactly it is. It was a long and strenuous ordeal w/ the insurance company but finally I was able to get the mass removed last Tuesday. I am still recovering from my surgery and just yesterday I received the pathology report which stated that the mass was only a nasopalatine duct cyst. I was so relieved now, my Dr has told me that there may be a chance that the cyst could grow back and to come back to him in 6 months. I will let you know how everything went, but as for now I am very relieved to have this ordeal behind me and now I can just concentrate on recovery. This has been a very emotional situation for me, I saw many Dr's and most of them just read the first pathology report and said that I have cancer, I am glad that the Dr I'm seeing now took the time to re-exam all the reports and not rush into the maxillectomy. Anyhow I just wanted to tell you how much I appreciate you taking the time to talk to me regarding my matter. Thank you.
 
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Rod_Moser_PA_PhD responded:
That is quite a story...and quite an ordeal. Thank you so much for the update. As you can see, doctors do make errors...mistakes in diagnoses...and mistakes in judgements. The "thank you note" really should go to the pathologist. I bet pathologists rarely get notes of appreciation.

I hope that you have a speedy and complete recovery and that this mass never comes back again.


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