Histological features and malignant transformation of inverted papilloma

Abstract

Inverted papilloma (IP) is a primarily benign epithelial neoplasm with a propensity to transform to squamous cell carcinoma (SCC). Neither the etiology of IP nor the factors responsible for malignant transformation are fully known to date. A considerable number of histopathological grading systems have been suggested. It was the aim of this study to find histological parameters in IP that allow a prognosis concerning the occurrence of malignant transformation. In a group of 93 cases of IP, the patients' records, histological specimens and a questionnaire were evaluated. Thirteen patients had suffered a recurrence of a previously treated IP. SCC in the IP had been diagnosed in 12 of the cases. The histological specimen showed increased counts of mitosis and dyscariosis in the IP. All other histological parameters did not show a significant difference between the groups. History and symptoms proved to be nonspecific as well. Patients in the group with SCC were significantly older at the first diagnosis of IP than patients without carcinoma. This group also included a higher portion of male patients. Patients fulfilling the named histological criteria combined with male gender and higher age are a high-risk group in the necessary long-term follow-up.

In Inverted Papillomas HPV more likely represents incidental colonization than an etiological factor

“…The malignant alteration of IPs has been widely recognized [1,4,8,22,23,[42][43][44][59][60][61][62][63][64][65]. Of all carcinomas associated with IPs, 61% are synchronous and 39%, metachronous [66].…”

Common Head and Neck Cases in Our Consultation Referrals: Diagnostic Dilemmas in Inverted Papilloma

“…Eggers et al [6] reported a retrospective analysis of 93 cases and Katori et al [7] analysed a series of 39 cases of inverted papilloma to establish histological parameters to predict recurrence and malignant transformation. Multiple recurrences without malignancy were related to frontal sinus site, increased hyperkeratosis, presence of squamous epithelial hyperplasia, and increased mitotic index.…”

Bilateral inverted papilloma: A report of two cases and review of the current literature

“…The factors which are responsible for this malignant transformation are as yet not understood. A number of studies have been performed in an attempt to discover predictive characteristics for malignant change [28,29]. Eggers et al [28] studied 93 cases of inverted papilloma with regards to both patient and tumor characteristics.…”

“…A number of studies have been performed in an attempt to discover predictive characteristics for malignant change [28,29]. Eggers et al [28] studied 93 cases of inverted papilloma with regards to both patient and tumor characteristics. They concluded that certain histological features, namely increased mitotic count and dyscariosis, along with male gender and older age group put patients at a higher risk of malignant change.…”