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Research ArticleHead and Neck Imaging

Focal Hyperostosis on CT of Sinonasal Inverted Papilloma as a Predictor of Tumor Origin

D.K. Lee, S.K. Chung, H.-J. Dhong, H.Y. Kim, H.-J. Kim and K.H. Bok
American Journal of Neuroradiology April 2007, 28 (4) 618-621;
D.K. Lee
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S.K. Chung
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H.-J. Dhong
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H.Y. Kim
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H.-J. Kim
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K.H. Bok
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    Fig 1.

    CT images of a patient with inverted papilloma.

    A and B, Axial and coronal CT images show focal plaquelike hyperostosis in part of right ethmoid sinuses (arrows).

    C, Although tumor extends to the right maxillary sinus and nasal cavity, no additional foci of hyperostosis are seen. Intraoperative endoscopic examination confirmed the limitation of tumor origin to the ethmoid sinuses.

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    Fig 2.

    CT and MR images of patients with inverted papilloma of the maxillary sinus.

    A, Axial CT image of a patient with inverted papilloma shows cone-shaped focal hyperostosis involving the posterior wall of the left maxillary sinus (arrows).

    B, Sagittal T2-weighted MR image of the patient clearly shows the centrifugal pattern of tumor growth with a hyperostotic focus (white arrow) at the posterior wall of the left maxillary sinus, which was confirmed to be a tumor origin by surgery.

    C, Axial CT image of another patient shows cone-shaped hyperostosis (arrow) involving the anterior wall of the left maxillary sinus, which was proved to be the origin of inverted papilloma by intraoperative endoscopy.

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    Fig 3.

    Coronal CT image in a patient with inverted papilloma shows localized cone-shaped hyperostosis of the superior wall of the posterior ethmoid sinus (white arrow). Intraoperative endoscopic examination confirmed that the origin of tumor was located at the superior wall of the right posterior ethmoid sinus.

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    Table 1:

    CT relationship between the origins of inverted papilloma and areas of focal hyperostosis

    Origin of Inverted Papilloma Confirmed by SurgeryCases* (n)Focal Hyperostosis on CTCoincidence of Focal Hyperostotic Area with Tumor Origin
    Lateral nasal wall402521
    Maxillary sinus191111
    Anterior ethmoid sinus161210
    Frontal sinus522
    Sphenoid sinus533
    Posterior ethmoid sinus211
    Septum211
    • * In 12 patients, tumor origin extended to more than one compartment of the sinonasal cavity.

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    Table 2:

    CT patterns of focal hyperostosis in inverted papilloma

    Sites Having Areas of HyperostosisCone-Shaped Hyperostosis on CT (n)Plaque-Like Hyperostosis on CT (n)
    Lateral nasal wall025*
    Maxillary sinus65
    Anterior ethmoid sinus012†
    Frontal sinus20
    Sphenoid sinus21
    Posterior ethmoid sinus10
    Septum10
    • * Four of the lesions proved not to coincide with the origin of tumor.

    • † Two of the lesions proved not to coincide with the origin of tumor.

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American Journal of Neuroradiology: 28 (4)
American Journal of Neuroradiology
Vol. 28, Issue 4
April 2007
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Cite this article
D.K. Lee, S.K. Chung, H.-J. Dhong, H.Y. Kim, H.-J. Kim, K.H. Bok
Focal Hyperostosis on CT of Sinonasal Inverted Papilloma as a Predictor of Tumor Origin
American Journal of Neuroradiology Apr 2007, 28 (4) 618-621;

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Focal Hyperostosis on CT of Sinonasal Inverted Papilloma as a Predictor of Tumor Origin
D.K. Lee, S.K. Chung, H.-J. Dhong, H.Y. Kim, H.-J. Kim, K.H. Bok
American Journal of Neuroradiology Apr 2007, 28 (4) 618-621;
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