==== Front Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 2747891710.5144/0256-4947.2016.298aasm-4-298aWhat's Your Diagnosis?Diagnosis: Oro-naso-hypopharyngeal inverted papilloma Thakur Kuldeep aBhoil Rohit bBhoil Rohan cAhluwalia Ajay b a Department of Otolaryngology, Dr. Rajendra Prasad Government Medical College, Kangra, India b Department of Radiodiagnosis, Dr. Rajendra Prasad Government Medical College, Kangra, India c Department of Prosthodontics, Armed Forces Medical College, Pune, IndiaCorrespondence: Dr. Rohit Bhoil, Department of Radiodiagnosis, Dr. Rajendra Prasad Government Medical College, Kangra, India, rohitbhoil@gmail.com, ORCID: http://orcid.org/0000-0002-5155-8325Jul-Aug 2016 36 4 298 298 Copyright © 2016, Annals of Saudi Medicine2016This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. ==== Body Inverted papilloma is a benign epithelial tumor with locally invasive nature commonly seen in the nasal cavity. It is named after its characteristic histological feature, that is, inversion of columnar or ciliated epithelium into the underlying stroma.1 It is an uncommon tumor comprising 0.5%–4% of primary tumors of the nasal cavity.1 It is significant due to its tendency to recur and due to synchronous as well as metachronous malignancies.2 It arises from the Schneiderian membrane of ectodermal origin, which is different from the endodermally derived mucosa of the respiratory tract.2 The etiology is not well established; however, human papillomavirus DNA has been implicated.3 The commonest site of origin is the lateral wall of the nasal cavity.2 The usual presentation is with unilateral nasal discharge (occasionally blood stained) with progressive nasal obstruction. The growths are usually pinkish and polypoidal in the lateral wall of the nasal cavity. Contrast-enhanced computed tomography revealed focal hyperostosis at the site of origin in the nasal cavity.2,3 A nasal mass with convoluted cerebriform pattern on the enhanced T1-weighted image on the magnetic resonance imaging scan usually suggests inverted papilloma.4 The diagnosis is confirmed on biopsy. The treatment of choice is wide excision, preventing recurrence. Radiation therapy is used in nonresectable tumors, residual tumors, and inverted papilloma associated with squamous cell carcinoma.5 Conflict of interest/financial support None. ==== Refs REFERENCES 1 Ringertz N Pathology of malignant tumours arising in the nasal and paranasal cavities and maxilla Acta Otolaryngol (Stockh) 1938 27 suppl 31 42 2 Pasquini E Sciarretta V Farneti G Inverted papilloma: report of 89 cases Am J Otolaryngol 2004 25 178 85 15124167 3 Hwang CS Yang HS Detection of Human papilloma virus (HPV) in sinonasal inverted papillomas using polymerase chain reaction (PCR) 1998 Sep-Oct 12 5 363 6 4 Jeon TY Kim HJ Chung SK Sinonasal inverted Papillomas: Value of Convoluted Cerebriform Pattern on MR imaging American Journal of Neuroradiology 2008 9 29 1556 60 18499786 5 Gomez JA Mendenhall WM Tannehill SP Radiation therapy in inverted papilloma of the nasal cavity and paranasal sinuses Am J Otolaryngol 2000 2 174 8