A 14-year-old boy has long-standing unilateral nasal obstruction with a smooth grey mass filling the left nasal cavity and extending into the nasopharynx. Endoscopy shows the mass emerging from the middle meatus. CT shows a homogeneous soft tissue mass arising from the left maxillary antrum with widening of an accessory ostium. The most likely diagnosis is:

• A Antrochoanal polyp ✓
• B Juvenile nasopharyngeal angiofibroma
• C Inverted papilloma
• D Ethmoid mucocele

Explanation

An antrochoanal polyp (Killian polyp) arises from the maxillary antral mucosa, typically near an accessory ostium, passes through the middle meatus and extends posteriorly into the choana and nasopharynx. It occurs in children and young adults, is usually single and unilateral, and contains no eosinophilic infiltrate. An angiofibroma arises from the sphenopalatine region in adolescent males and is intensely vascular, while inverted papilloma arises from the lateral nasal wall proper.

Reference: Scott-Brown's Otorhinolaryngology Head and Neck Surgery, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.