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Potentially distinctive features of sinonasal inverted papilloma on MR imaging
1Department of Radiology, Jikei University School of Medicine, Nishi-shimbashi, Minato-ku, Tokyo, Japan.
Objective:
The objective of this study is to describe potentially distinctive MR features of sinonasal inverted papilloma and those of coexisting squamous cell carcinoma.
Conclusion:
A sinonasal mass with a convoluted cerebriform pattern on T2- or enhanced T1-weighted images suggests inverted papilloma as a histologic diagnosis. Necrosis in a mass with such an appearance strongly suggests coexistent carcinoma.
Insights
Magnetic resonance imaging (MRI) can identify sinonasal inverted papilloma. The presence of necrosis within a convoluted mass on MRI suggests coexisting squamous cell carcinoma.
Area of Science:
- Radiology
- Oncology
- Otorhinolaryngology
Background:
- Sinonasal inverted papilloma (SIP) is a benign neoplasm requiring accurate diagnosis.
- Distinguishing SIP from malignant tumors like squamous cell carcinoma (SCC) is crucial for treatment planning.
Purpose of the Study:
- To delineate unique magnetic resonance (MR) imaging characteristics of sinonasal inverted papilloma.
- To identify MR features indicative of concurrent squamous cell carcinoma in sinonasal masses.
Main Methods:
- Retrospective analysis of MR imaging features in patients with sinonasal inverted papilloma.
- Comparison of imaging findings between pure inverted papilloma and those with coexisting squamous cell carcinoma.
Main Results:
- A convoluted, cerebriform pattern on T2-weighted or enhanced T1-weighted MR images is suggestive of inverted papilloma.
- The identification of intralesional necrosis within such a pattern strongly indicates the presence of coexistent squamous cell carcinoma.
Conclusions:
- MR imaging can aid in the preoperative diagnosis of sinonasal masses.
- Specific imaging patterns, particularly the convoluted cerebriform appearance with necrosis, are key indicators for differentiating benign inverted papilloma from malignant transformation to squamous cell carcinoma.