🩻This mass originates in the right maxillary sinus and extends into the nasal cavity via the maxillary ostium. Can you appreciate the alternating lines of hyperintensity and hypointensity on the T2-weighted and post-contrast images? This is the "convoluted cerebriform pattern" typical of an inverted papilloma.
🔬These account for 3 - 5% of sinonasal tumours. While benign, there is a significant risk of malignant transformation (5 - 15%), usually to squamous cell carcinoma, and a propensity for recurrence.
💡Focal loss of the cerebriform pattern may indicate a site of malignant transformation.
💡On CT, an area of hyperostosis suggests the site of tumour origin; this will need to be removed after stripping the overlying mucosa.
💡The cerebriform pattern is not unique to inverted papillomas and can also be seen, rarely, in other sinonasal tumours.