Head & Neck Case Review 2021-12

Head & Neck Case Review

December, 2021


An elderly man presented with a maxillary sinus mass. Physical exam showed softness of the right hard palate and a nasal endoscopy showed a mass extending into the right maxillary sinus. A CT and MRI showed a mass within the right maxillary sinus with bowing of the medial maxillary wall and cortical breakthrough of the posterior wall. The mass demonstrated extension into the fat of the right masticator space and involvement of the right maxilla.  A biopsy of the mass was performed. Representative imaging of the mass along with H&E stained sections and immunohistochemical stains of the biopsy are shown.



  1. Which of the following best characterizes the process shown?
  • A. Clusters of benign remnant epithelial cell rests
  • B. A reactive inflammatory process disrupting normal epithelial elements
  • C. A malignant epithelial process
  • D. A malignant process derived from embryologic remnants

2. What is the immunohistochemical stain shown in the last image?

  • A. p63
  • B. Brachyury
  • C. SOX-10
  • D. WT1



Troy Hutchens, MD, PhD
Head & Neck Surgical Pathology Fellow
Department of Pathology & Immunology
Washington University School of Medicine