Endoscopic management of extensive inverted papilloma: technical challenges and outcomes

BACKGROUND. Inverted papilloma is a clinically significant benign tumor of the sinonasal tract due to its locally aggressive behaviour, potential for malignant transformation, and frequent involvement of anatomically complex regions. Its presentation often mimics other inflammatory or neoplastic conditions, making early diagnosis and tailored surgical management essential for preventing functional and structural complications.

CASE REPORT. This case presents a rare and extensive bilateral sinonasal inverted papilloma with externalization through the nasal vestibule, occurring in a patient with a history of prior sinonasal surgery and significant anatomical distortion. The tumor’s aggressive local expansion, associated bone remodelling, and metaplastic ossification posed considerable diagnostic and surgical challenges, successfully managed through advanced endoscopic techniques.