Inverted papilloma

Case contributed by Mostafa Elfeky
Diagnosis probable


Chronic nasal obstruction.

Patient Data

Age: 55 years
Gender: Male

Paranasal Sinuses MRI


Sizable space occupying lesion expanding the left maxillary sinus and its outflow tract together with the left ostio-meatal complex notably the ethmoid infundibulum. It is expanding to near totally filling the cavity of the left maxillary antrum that is otherwise showed mild thick mucosa and retained secretions within its most anterior aspect.

The lesion is reaching the region of the left middle nasal meatus that is expanded with impaction of the left bulla ethmoidalis and the anteroinferior left ethmoid air cells. It showed T1 and T2 alternating lines of high and low signal intensity together with evident enhancement after contrast administration (convoluted cerebriform pattern). No intra-orbital extension or extension to the pterygopalatine fossa.

Case Discussion

Inverted papilloma (Schneiderian papilloma) is a benign sinonasal swelling that causes nasal obstruction. It is centered upon the lateral wall of the nasal cavity and maxillary ostium extending to the maxillary antrum with expansion and bony remodeling. The described convoluted cerebriform pattern is seen in most cases.

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