Rock, paper, endoscopy : a baffling case of rhinolith

A 60-year-old woman presented with a bulky nasal mass. The mass was accidentally discovered during examination following a head injury. The patient, suffering from severe mental retardation, did not complain of any nasal symptoms, though her relatives, upon direct questioning, reported a two year history of fetid rhinorrhoea and occasional epistaxis. The CT scan showed a large inhomogeneous calcified mass in left nasal cavity, impacted on the choanal border. The patient underwent endoscopic nasal surgery under general anaesthesia in order to remove the mass. A transnasal approach granted a successful and complete removal. The patient was discharged the following day without any complication and no sign of recurrence or symptoms relapse was reported during a two year follow-up