Differential Diagnosis for Mucosal Thickening and Soft Tissue in the Posterior Aspect of the Right Maxillary Sinus
- Single most likely diagnosis
- Sinusitis with extension into the pterygopalatine fossa: This is the most likely diagnosis due to the presence of mucosal thickening and soft tissue in the posterior aspect of the right maxillary sinus, which are common findings in sinusitis. The new erosion of the posterior bony wall and soft tissue filling the right pterygopalatine fossa suggest extension of the infection or inflammation into the surrounding tissues.
- Other Likely diagnoses
- Odontogenic infection: The location of the findings, particularly the involvement of the posterior maxillary sinus and the pterygopalatine fossa, could suggest an odontogenic infection originating from the upper molars.
- Nasopharyngeal carcinoma with sinus invasion: Although less common, nasopharyngeal carcinoma can invade the sinuses and cause erosion of the bony walls, making it a possible diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Malignant tumor (e.g., squamous cell carcinoma, adenocarcinoma): It is crucial to consider malignant tumors in the differential diagnosis, as they can present with similar findings and have a significant impact on prognosis and treatment.
- Invasive fungal sinusitis: This is a rare but potentially life-threatening condition, especially in immunocompromised patients. The presence of new erosion and soft tissue filling the pterygopalatine fossa could suggest invasive fungal sinusitis.
- Rare diagnoses
- Wegener's granulomatosis (Granulomatosis with Polyangiitis): This is a rare autoimmune disorder that can cause sinusitis and destruction of the surrounding tissues, including the bony walls of the sinuses.
- Langerhans cell histiocytosis: This rare condition can cause erosive lesions in the bones, including the sinuses, and should be considered in the differential diagnosis, especially in younger patients.