Question

A patient complains of nasal congestion, discharge, and intermittent nasal bleeding for the past two months. There is also a history of spontaneous exfoliation of an upper molar tooth. What is the most likely clinical diagnosis?

• A. Maxillary sinus adenoma
• B. Maxillary sinus malignancy
• C. Chronic maxillary sinusitis
• D. Tubercular sinusitis

Hint:

Unilateral nasal symptoms + epistaxis + unexplained loosening of upper posterior teeth = Suspect maxillary sinus malignancy.

Answer 1

The Correct Option is B

Step 1: Analysis of Symptoms.
The patient presents with nasal congestion, discharge, and intermittent epistaxis for two months.
Epistaxis (nasal bleeding) is a warning sign, especially when persistent.
Step 2: Significance of Tooth Exfoliation.
Spontaneous exfoliation of an upper molar without obvious periodontal cause suggests underlying bone destruction.
The roots of upper molars are closely related to the maxillary sinus.
A malignant lesion in the sinus can invade alveolar bone and cause tooth mobility or exfoliation.
Step 3: Evaluation of Options.
Maxillary sinus adenoma is rare and usually not associated with bone destruction.
Chronic sinusitis causes congestion and discharge but not spontaneous tooth loss.
Tubercular sinusitis is uncommon and does not typically present with such aggressive bone involvement.
Maxillary sinus malignancy commonly presents with epistaxis, nasal obstruction, and loosening of upper teeth.
Step 4: Conclusion.
Therefore, the most likely clinical diagnosis is maxillary sinus malignancy.