Amyloidosis Presenting as a Solitary Nasal Mass

Amyloidosis is characterized by extracellular deposition of amyloid fibrils. Localized collection of amyloid material in the form of a mass is extremely rare. Mr. M presented with epistaxis and was found to have a friable mass in the right maxillary antrum. Excision was followed by the resolution of symptoms, and histopathology revealed subepithelial collection of amorphous pink material. It was positive for methyl violet and Congo red stain and showed apple-green birefringence. Staining for serum amyloid A and kappa/lambda light chains were negative. Workup for multiple myeloma, positron emission tomography scan for other masses, and screening for end-organ damage was also negative. He continues to be asymptomatic on observation 1-year after presentation. Amyloidosis presenting as a nasal mass has been described in less than five patients so far. Local excision appears to be the best treatment and is associated with a low risk of recurrence on long-term follow-up.