A 90-year old man presented with a 9-month history of chronic nasal congestion and recurrent left-sided epistaxis. He denied facial pain, headaches, or recurrent sinusitis. His medical history was notable for thrombocytopenia due to myelodysplastic syndrome. Nasal endoscopy showed an irregular purple mass emanating from the left middle meatus (Figure 1). A computed tomographic scan showed total opacification of the left maxillary sinus, with erosion of the medial, inferolateral, and posterior walls of the maxillary sinus (Figure 2).