[Clinical Picture] Mid-face bone destruction involving the palate

A 19-year-old woman who did not smoke, drink alcohol, or use recreational drugs presented at the Department of Oral Medicine, Tel Hashomer, Medical Corps (Israel) in January 2008, with a 3-month history of intermittent fever, nasal and conjunctival discharge, and palatal pain. Examination revealed extraoral left nostril asymmetry and obstruction, and an intraoral extensive indurated ulcer in the midline of the hard palate (figure, A). CT scan showed massive mid-face bone destruction involving the palate, nose, and maxillary and ethmoidal sinuses, extending into the skull base (figure, B).

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