Organized hematoma (OH) is a rare, benign, rapidly expanding mass that mimics malignant or locally aggressive neoplasm, thereby leading to a diagnostic dilemma. OH mainly affects the maxillary sinus, and involvement of the nasal cavity and septum is seldom reported. Herein, we report a novel case of OH mimicking a malignant tumor, arising from the nasal cavity in a 30-year-old male patient of Indian origin who presented with complaints of bilateral nasal obstruction (left > right) with a mass coming out of the left nostril. CT of paranasal sinuses revealed markedly diffuse expansile polypoidal mucosal thickening with multiple bony erosions and bony destruction. MRI of paranasal sinuses suggested pansinusitis with multiple small bony erosions along the anterior wall of frontal and maxillary sinuses (left > right). Scans showed an ill-defined heterogeneous polypoidal enhancing lesion (4.7×5.1×5.8 cm) involving the entire nasal cavity with destruction of nasal septum. Patient underwent total excision of the mass. Microscopic examination revealed sinonasal polypoid fragments with extensive ulceration, hemorrhage, and fibrosis suggestive of OH. At 6-months follow-up, the patient was asymptomatic without any recurrence.

Case Report, Imaging, Nasal Cavity, Nasal Septum, Organized Hematoma.