Clinicopathologic Characteristics of Unilateral Sinonasal Masses in Pediatric Patients

This retrospective study evaluated the etiologic spectrum and diagnostic features of pediatric unilateral sinonasal masses (USMs) and compared their histopathologic distribution with adults. Pediatric patients (<18 years) treated between 2009 and 2025 with histopathologically confirmed USMs were analyzed for demographic, clinical, radiologic, and pathologic data, alongside a comparable adult cohort. Among 70 pediatric patients (median age: 14 years), inflammatory lesions predominated (67%), followed by benign neoplasms (19%), miscellaneous lesions (9%), and malignant neoplasms (6%). Compared to 310 adults, children had significantly higher inflammatory and lower neoplastic lesion rates. Malignancies in children typically presented with facial swelling and showed bone erosion with extrasinus extension on imaging. Diagnostic biopsy identified malignancy only in lesions with these high-risk features and enabled non-surgical management or neoadjuvant therapy planning. Overall, pediatric USMs are mostly inflammatory and differ markedly from adult cases. A risk-stratified diagnostic approach with selective biopsy use is appropriate for pediatric patients.