Diagnosis Definition
- IPs (a subtype of Schneiderian Papillomas) are benign, locally aggressive lesions composed of pseudostratified respiratory epithelium that account for 0.4-4% of nasal cavity masses
- They typically originate from the lateral wall of the nasal cavity, although they may also arise from the paranasal sinuses, and grow inward and into the underlying bone
- IPs are often resected, as up to 10% undergo malignant transformation, most commonly into squamous cell carcinoma
- The rate of recurrence after resection is between 2 and 15%
Imaging Findings
- Imaging is insufficiently specific to reliably differentiate an IP from other benign (inflammatory or antrochoanal polyps) and malignant (sinonasal carcinoma) masses
- On CT, IPs appear as an enhancing nasal or sinus mass, which may widen the maxillary infundibulum; identification of a hyperostotic stalk favors IP over other sinonasal masses and can help direct the surgical approach
- On MRI, IPs classically demonstrate a “cerebriform” or “brainlike” appearance, seen as heterogeneous alternating hypointense and hyperintense bands on T2-weighted and contrast-enhanced T1-weighted images
KEY IMAGES
This diagnosis has no attached images.
Pearls
- Classic features on CT (hyperostotic stalk) and MRI (cerebriform T2 signal) favor the diagnosis of IP
References
- Chawla A, Shenoy J, Chokkappan K, Chung R. Imaging features of sinonasal inverted papilloma: a pictorial review. Current Problems in Diagnostic Radiology 2016; 45(5):347-53
- Ojiri H, Ujita M, Tada S, Fukuda K. Potentially distinctive features of sinonasal inverted papilloma on MR imaging. American Journal of Roentgenology 2000; 175:465-468
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