Case presentation A young man presented to the ED with facial trauma post an assault. Physical examination marked tenderness over the nasal bones. CT scan (without contrast) of the bone showed a fracture of the nasal bone and a 7 mm tissue density within the posterior aspect of the left sphenoid sinus (Image A).

An MRI with contrast revealed a transosseous, multilobulated mass of size 2.1 ร— 1.4 ร— 1.3 cm with heterogenous enhancement extending into the sphenoid sinus. Pathological examination of the tissue biopsy specimen showed sheets of neoplastic, vacuolated, soap-bubble-like cell structure with a myxoid background (Image B).