A 58-year-old male smoker presents with three months of left facial pain, recurrent epistaxis, and loosening of his left upper molar teeth. Examination shows a mass in the oral vestibule and fullness of the alveolus. Intraoral dental extraction was done twice with no relief. The most likely diagnosis is:
- A Carcinoma of the maxillary sinus invading the alveolus ✓
- B Carcinoma of the alveolar ridge
- C Periapical abscess of the maxillary molars
- D Ameloblastoma of the maxilla
Correct answer: A. Carcinoma of the maxillary sinus invading the alveolus
Explanation
Loosening of the upper molar teeth, unexplained dental pain, and failure after extractions are classic features of carcinoma of the lower infrastructure of the maxillary sinus eroding the alveolar process and palate. Dental symptoms are a well-known mode of presentation that delays diagnosis because patients first seek dental care. C periapical source would have resolved with extraction. Ameloblastoma is slow growing, expansile, and does not cause epistaxis.
Reference: Scott-Brown's Otorhinolaryngology Head and Neck Surgery, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.