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Inverted papilloma

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Prolonged left sided nasal fullness and facial discomfort.

Patient Data

Age: 40 years
Gender: Male
ct

Left sinonasal mass centered on the middle turbinate, destroying the medial orbital wall, septae of the ethmoidal air cells and thinning the floor of the anterior cranial fossa.

Widening of the left osteomeatal complex.

The left maxillary sinus is completely opacified.

mri

The MRI, in particular the T2W sequence, beautifully delineated the mass in the ethmoids extending into the ipsilateral frontal sinus from fluid in the left maxillary and frontal sinuses.

Case Discussion

An inverted papilloma is an uncommon benign sinonasal tumor with distinctive pathological and imaging features.

MRI is very useful if delineating the extent of the mass in relation to post-obstructive fluid and the sinuses involved to aid the surgical approach.

The CT is essential in outlining bony destruction.

Combined CT and MRI is, therefore, the gold standard.

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