007. Her main complaint was nasal blockage and recurrent nose bleeds for three months. viagra without prescription The condition started by progressive painless nasal obstruction, snoring and mouth breathing. The condition was not associated with any other systemic manifestations or family history of a similar condition. On examination she looked ill, afebrile, pale and not cyanosed or jaundiced.   anterior and posterior rhinoscopy revealed a mass completely occluding the nasopharynx. The soft palate was obviously pushed forward & downwards and no other abnormality was detected. can i buy viagra in hong kong Otoscopy showed normal right tympanic membrane with positive rinnie`s test and a retracted left tympanic membrane with negative rinnie`s test. ordering viagra online without visiting a doctor No abnormality was detected on indirect laryngoscopy or neck examination. yahoo can buy viagra No abnormality was detected on systemic examination including the central nervous system. buy viagra online Complete blood count showed normocytic normochromic rbcs, neutrophilia with moderate toxic granulation and reactive lymphocytes, slightly increased platelets with few giant forms, and esr of 80mm\1st hour. The specific gravity of her urine was 1. 030 and microscopy revealed three crosses of urate crystals.   c-t scan non contrast axial, coronal and segittal sections of the paranasal sinuses, nasopharynx& oropharynx showed a 7. 5 cm. X 5. can i buy viagra in hong kong 7 cm. Oro-nasopharyngeal soft tissue mass severely compromising the oropharyngeal airway and completely obstructing the nasal cavity. There was also thickening of the mucous membrane lining the paranasal sinuses, butno evidence of bony destruction or erosion. (figures 1: a, b and c). viagra online                               a                                                     b                                                  c figures 1: c-t scan non contrast axial (a & b) and segittal (c ) sections of the paranasal sinuses, nasopharynx& oropharynx showed a huge oro-nasopharyngeal soft tissue mass severely compromising the oropharyngeal airway and completely obstructing the nasal cavity.   examination under anesthesia revealed a large friable, spongy, polypoidal mass filling the oropharynx and nasopharynx with wide base attached to the supero-posterior wall of the nasopharynx. The mass was removed by transoral digital inoculation with only mild bleeding which was controlled by pressure packing. The tumour base was curetted by adenoid curette to remove any remaining tissues. Anterior and posterior nasal packs were applied. can i buy viagra in hong kong The mass specimen was sent for histopathology which was reported as aggregates of fragmented biopsy showing prominent stag horn vascular channels and fanning out diffuse sheets of bland spindle cells. cheapest viagra price Features were keeping with  hemangiopericytomaof the nasal cavity. Margins could not be assessed in a fragmented specimen. cheap viagra online (figures 2: a, b and c).   discussion despite that 90% hpc cases arise in the age group 50-70 years. everyday viagra online



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