Inverted papilloma - sinonasal

Case contributed by Derek Smith


18 months of right nasal stuffiness, now aware of mass.

Patient Data

Age: 55 years
Gender: Male

Large right nasal cavity mass (11 cm); expansion of ostiomeatal complex and posteriorly fills nasopharynx and comes across to left choana.

Thinning of lamina papyracea but no intraorbital soft tissue abnormality. No intracranial breach.

Evidence of chronic obstruction with right pterygoid base sclerosis, maxillary hyperostosis with erosion lateral maxillary wall.

No variant sinus anatomy.

Anatomical findings as on CT.

Cerebriform pattern on T2w and enhancing sequences.

No intracranial abnormalities.

Case Discussion

The convoluted cerebriform MRI appearance is typical of inverted papillomas, and not often seen in other sinonasal tumors. This diagnosis was confirmed on en bloc resection with Schneiderian papilloma, inverted type, with no features of dysplasia or malignancy.

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