A 40-year-old man presents with progressive right-sided facial pain and nasal obstruction. Non-contrast CT of the paranasal sinuses shows a homogeneous, expansile, non-enhancing soft tissue mass filling the right ethmoid and maxillary sinuses with thinning and remodeling of the medial wall of the orbit. The most likely diagnosis is:

• A Inverted papilloma
• B Squamous cell carcinoma
• C Allergic fungal sinusitis
• D Sinonasal mucocele ✓

Explanation

Mucocele presents as an expansile, non-enhancing, homogeneous paranasal sinus mass causing bony thinning and remodeling, often with orbital wall displacement. Squamous cell carcinoma would show bony destruction and heterogeneous enhancement. Inverted papilloma typically shows a convoluted gyral pattern on MRI and is more often unilateral in the lateral nasal wall. Allergic fungal sinusitis shows hyperdense central material on CT.

Reference: Radiology Review Manual, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.