Sinonasal myxoma involving the anterior skull base in an infant: A case report

Sinonasal myxomas are rare neoplasms in the pediatric population. We present a case of extensive sinonasal myxoma involving the anterior skull base in an infant. A 16-month-old African-American female was initially referred to our clinic for evaluation of a possible nasal fracture after falling. Examination demonstrated mild nasal edema, but there was no sign of fracture. Over several weeks, the swelling progressed, and the left eye became proptotic. Imaging demonstrated a massive sinonasal mass involving the skull base. The patient underwent transnasal endoscopic biopsy, which was diagnostic of myxoma. Complete extirpation of the lesion was performed via a combined subcranial, sublabial, and transnasal endoscopic-assisted approach. Her postoperative course was unremarkable and she remained symptom-free with no evidence of disease seven months later. Sinonasal myxoma is rare disease in the pediatric population with the propensity to be locally aggressive. Histologically, it resembles other disease processes, making diagnosis challenging. Endoscopic-assisted approaches can facilitate complete extirpation.