Inverted papilloma

Case contributed by Dr Ian Bickle

Presentation

A patient with nasal stuffiness presented to ENT. A left sinonasal mass was identified.

Patient Data

Age: 40 years
Gender: Male
CT

Left sinonasal mass centered on the middle turbinate with opacification of the left maxillary sinus.

No bony destruction or exostosis.

MRI

A mass with alternating roughly parallel lines of high and low signal intensity is present on T2.  The mass avidly enhanced following contrast.

The left maxillary sinus contains only a small amount of tumor, but contains fluid as the osteomeatal complex is obstructed by the papilloma.

The inferior turbinate is displaced, but not involved.

Case Discussion

The is a classic example of a inverted papilloma demonstrating the typical convoluted cerebriform pattern and demonstrating the value of MRI over CT in pre-operative imaging.

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