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History of Present Illness:

A 37-year-old woman presented to an endocrinologist with chronic daily headache and hyperprolactinemia. The patient reported a several-month history of bifrontal headache that was at times severe and associated with nausea. She denied facial numbness or diplopia, but reported 2 transient episodes of blurry vision that spontaneously resolved. She denied nasal obstruction, epistaxis, purulent or copious clear rhinorrhea, trismus, neck mass, fever, chills, or night sweats.

Magnetic resonance imaging (MRI) of the brain was obtained, which did not reveal a sellar lesion, but instead demonstrated the incidental finding of a well-demarcated mass of the right pterygopalatine and infratemporal fossae. The patient was subsequently referred to the Division of Rhinology & Skull Base Surgery for further management.

Patient History

The patient had no history of sinonasal or skull-base surgery, nor symptoms of recurrent acute or chronic rhinosinusitis, and was otherwise healthy. She was employed as a nurse.




Please use the discussion feature below to ask the authors your questions and provide further feedback on others’ questions. All questions and replies are moderated.


  1. Dr Shakil Aqil

    The pt would need endoscopic biopsy of the mass from pterygopalatine fossa.

    1. Dr Shakil Aqil

      Dofferential diagnosis

  2. Nelson Davila

    Good Morning. Did this patient have signs of epiphora, dry eye, proptosis? Changes in ocular mobility or visual field?

  3. Bestari budiman

    Its a rare and difficult case, amazing to follow what kind the solve this problem,..

  4. Ana Chávez

    Please i can see the Images Of IRM ?


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