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Organized hematoma of the maxillary sinus: a case report. Problem: Clinical and radiographic diagnosis of organized hematoma remains challenging, and occurrence in the paranasal sinuses is rare.
Case report: A 53-year-old patient noted gradual malar swelling and a fibrinous protrusion in the left maxillary buccal sulcus over several weeks. Following multiple episodes of spontaneous intraoral bleeding and epistaxis, an extensive mass was identified in the left maxillary sinus. Computed tomography revealed osteolysis of the lateral, medial, and inferior sinus walls. Expecting malignancy, repeated needle biopsies were performed. However, pathologic examination showed only fibrin and blood with signs of organization, and no atypical cells. In the absence of malignancy, a diagnosis of organized hematoma was postulated.
Conclusions: Oral breakthrough is a rare presentation of this difficult diagnosis. This case report raises awareness, aids in clinical characterization, and highlights the most appropriate treatment.