Case Of the Week (COW) 01 November 2015
INVERTED PAPILLOMA
Findings
T1 hypo, T2 iso hypointense lesion showing cerebriform appearance noted involving left nasal cavity displacing the nasal septum to the right side causing narrowing of right nasal cavity. The lesion extends into the maxillary sinus on the left side causing indentation of anterior wall of left maxillary sinus. The lesion shows heterogeneous contrast enhancement. No intracranial/intra orbital extension made out. Retained secretions noted in frontal sinus sphenoid sinus due to obstruction of sinus ostium by the tumour.
Discussion
associated with HPV-11, location:mostly unilateral, most often arise from lareral nasal wall with extn, into ethmoid/maxillary sinus unilateral nasal obstruction,epistaxis,sinus headache &sinusitis MR:intermediate to low intensity in T2WI with homogeneous contrast enhancement with characteristic "cerebriform " appearance may cause widening of infundibulum/outflow tract of antrum destruction of medial wall/lamina papyracea of orbit & septum bowed to opposite side.. ddx: squamous cell carcinoma,melanoma,olfactory neuroblastoma,small cell carcinoma.
Contributed By:
Dr. Amarnath Selvaraj
Barnard Institute of Radiology
INVERTED PAPILLOMA
Findings
T1 hypo, T2 iso hypointense lesion showing cerebriform appearance noted involving left nasal cavity displacing the nasal septum to the right side causing narrowing of right nasal cavity. The lesion extends into the maxillary sinus on the left side causing indentation of anterior wall of left maxillary sinus. The lesion shows heterogeneous contrast enhancement. No intracranial/intra orbital extension made out. Retained secretions noted in frontal sinus sphenoid sinus due to obstruction of sinus ostium by the tumour.
Discussion
associated with HPV-11, location:mostly unilateral, most often arise from lareral nasal wall with extn, into ethmoid/maxillary sinus unilateral nasal obstruction,epistaxis,sinus headache &sinusitis MR:intermediate to low intensity in T2WI with homogeneous contrast enhancement with characteristic "cerebriform " appearance may cause widening of infundibulum/outflow tract of antrum destruction of medial wall/lamina papyracea of orbit & septum bowed to opposite side.. ddx: squamous cell carcinoma,melanoma,olfactory neuroblastoma,small cell carcinoma.
Contributed By:
Dr. Amarnath Selvaraj
Barnard Institute of Radiology