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Results of sinus CTscan????
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Results of sinus CTscan????

I have chronic sinusitis.  I had a CTscan of the sinuses a few months ago through my ENT and the NP called and said it was OK. I went to see the ENT today because my sinuses and throat and ear were really bad and he started to say something like the scan was OK but there was something and somehow we got off the track as he wanted to proceed with the endoscopy of the throat area.

I stopped by the medical records dept where the CTscan was done and got a copy of the written report which is the same as he got (he did not see the actual scan) and everything was normal until the last part which read: "Mild asymmetric prominence of the left fossa of Rosenmuller within the nasopharynx without evidence of adenopathy are present." AND then at the bottom of the report under

Impression: it stated "Asymmetiric prominence of the left fossa of Rosenmueller. Recommend direct correlation to exclude underlying neoplastic process".  That neoplastic word scared me as I know it means cancer.

I called the office when I got home and he got on the phone and said straight out the scan was normal. So, do I just forget about the exam report and take his word for it that everything is OK? I don't want to bug him about it and make him angry but it has me worried now.  He doesn't know I got a copy.

Perhaps that prominence is something he sees all the time and is not bad. The last CTscan I had a few years ago did not have that written on it.

He wasn't interested in looking up the nose with the endoscope, only down the lower throat area so I know he wasn't trying to see anything up there.  He says he definitely saw acid reflux splash in the lower area of the throat and I am on Prevacid and Zantac

I really don't know what to do now. I know he did not have the report in front of him when he spoke to me at home and not even sure he looked at it in the office. All I really have to go by is the fact the NP called after they got the results and said it was OK.???

Thanks so much for your help.
242588_tn?1224275300
Tumors of the nasopharynx are relatively rare in the U.S. but symptoms are often ignored or attributed to sinusitis, with delay in making the diagnosis.  The radiology report of "Asymmetric prominence of the left fossa of Rosenmuller.  Recommend direct correlation to exclude underlying neoplastic process" must not be ignored.  Neoplasm is a scary word.  The most common sites of origin of such tumors are the fossa of Rosenmuller and the nasopharyngeal roof, with 10% of the tumors being entirely beneath the mucus membrane that lines this area.

Given the ENT specialist's response to your query, and dismissal of your concern, it seems unlikely that he will want to pursue this any further.  But you must make that carefully considered decision.  You may want to seek a second opinion from an ENT specialist, completely unrelated to the initial specialist.  If so, you should first obtain copies of the CT scan to be taken to your first appointment.  The radiologist’s recommendation of "direct correlation" refers to direct examination of your naso-pharynx, especially the area of the fossa of Rosenmuller, with the use of a fiberoptic instrument called a laryngoscope.  You, or perhaps your primary care physician as your advocate, must insist that this examination be performed.

This is, potentially, too serious a situation for you not have this diagnosis ruled-out with much certainty and, an magnetic resonance imaging (MRI) may be necessary to do that, in addition to the direct exam.

Good luck.
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