Inverted papilloma is a rare benign sinonasal tumour, characterized by a po
tentially invasive nature. The lateral nasal wall represents the most commo
n site of origin, whereas paranasal sinuses are quite frequently found to b
e involved by extension. In contrast, primary sinus inverted papillomas hav
e rarely been reported. The present study describes an extremely rare case
of inverted papilloma. isolated to the left sphenoid sinus, that was treate
d by a transnasal endoscopic procedure. The therapeutic approach chosen is
discussed and the results of a two-year follow-up are also presented.