A 42-year-old female patient presenting with epistaxis, nasal obstruction and clear rhinorrhoea over 3 months. The patient had a personal history of human papillomavirusrelated (HPV) sinonasal carcinoma, with adenoid cystic-like features in the right nostril, treated 4 years earlier in a different institution by superomedial maxillectomy using an external approach plus postoperative radiotherapy. Nasal endoscopy revealed a mass occupying the cavity, with a biopsy compatible with recurrence of her initial tumour. Cervical, thoracic and abdominal CT revealed a right nasal mass that was infiltrating ethmoidal cells and touching the ipsilateral orbit. F