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An aerated middle turbinate is called a concha bullosa (CB), and given the importance of the middle turbinate in nasal physiology, variations that alter the airflow and mucous drainage can cause sinonasal symptoms. A pyocele of the middle turbinate differs from an infected CB because it has the potential to expand and destroy neighbouring tissues like a tumour. We present a concha bullosa pyocele (CBP) that expanded against the lamina papyracea without causing orbital displacement. As pus was discharged whilst performing an endoscopic biopsy to determine whether it was neoplastic, the lateral aspect of the turbinate was excised to complete the procedure. [ABSTRACT FROM AUTHOR]