Nasal blockage; Hard mass per examination; Painful.
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Non-contrast CT through the paranasal sinuses demonstrates a very large well circumscribed mass centred on the nasal septum. The mass is of high attenuation with a number of fluid density spaces within it. It has remodelled and resulted in resorption of the surrounding bony margins, as it has expanded into the orbits, anterior cranial fossa and maxillary sinuses (the outflow of which are compromised). The hard palate appears intact.
Features are consistent with an unusually large cemento-ossifying fibroma. This was subsequently histologically proven.