Sinonasal inverted papilloma: a rare case of isolated septal location

Introduction: Sinonasal inverted papilloma (IP) is a benign yet locally aggressive tumor that develops within the nasal cavities and paranasal sinuses. However, exclusive septal localization of this pathology is rare and has been increasingly capturing the medical community’s interest. Case presentation: A 54-year-old female reporting recurrent episodes of epistaxis presents on clinical examination grape-like polypoid lesions on the anterosuperior site of the right septal mucosa. Histopathological analysis of a biopsy favored an IP diagnosis. Treatment consisted of complete surgical excision through endoscopic removal of the polypoid septal mucosa and the septal perichondrium. Clinical discussion: When IP is suspected in an exclusive septal location, patients should undergo computed tomography imaging to assess features and explore possible sinonasal extensions. If confirmed by biopsy, comprehensive surgical removal of the IP and its mucoperiosteum is recommended. Rigorous postoperative monitoring including endoscopic follow-up and, when necessary, magnetic resonance imaging and biopsies, is crucial for suspected cases. Conclusion: Isolated septal IP is a rare yet intriguing clinical entity, demanding meticulous and multidisciplinary management. Its treatment is exclusively surgical, and long-term surveillance is imperative due to its considerable potential for recurrences.