Histopathological parameters of recurrence and malignant transformation in sinonasal inverted papilloma

Abstract

Malignancy was related to the presence of bone invasion (p=0.039), the absence of inflammatory polyp (p=0.033), increase in the ratio neoplastic epithelium:stroma (p=0.037), increase in hyperkeratosis (p=0.030), the presence of squamous epithelial hyperplasia (p=0.044), increase in the mitotic index (p=0.029) and a decrease in the number of eosinophils (p=0.037). Multiple recurrences (without malignancy) were related to frontal sinus origin (p=0.042), increase in hyperkeratosis (p=0.041), the presence of squamous epithelial hyperplasia (p=0.044) and increase in the mitotic index (p=0.031). Clinically benign behavior was related to the presence of inflammatory polyp (p=0.010) and the absence of hyperkeratosis (p=0.008).

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

“…Malignancy was associated with the presence of bone invasion, absence of inflammatory polyps, high ratio of neoplastic epithelium to stroma, increased hyperkeratosis and decreased eosinophils. Clinically benign behaviour was related to the presence of inflammatory polyp and absence of hyperkeratosis [7] (Fig. 1).…”

“…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.…”

Schneiderian Papillomas: Comparative Review of Exophytic, Oncocytic, and Inverted Types

“…2,10 Several factors have been shown to increase the risk of recurrence for IP including tobacco exposure, increased tumor size, increased hyperkeratosis, squamous epithelial hyperplasia, increased number of mitoses, bilaterality, and the lack of inflammatory polyps. 1,9,[27][28][29] In addition, IP originating from the frontal sinus tend to have multiple recurrences, likely because of technical difficulties operating in this location. 9,28 Most recurrences usually occur within the first 3 years, although recurrences 10 years postoperatively have been reported.…”

“…1,9,[27][28][29] In addition, IP originating from the frontal sinus tend to have multiple recurrences, likely because of technical difficulties operating in this location. 9,28 Most recurrences usually occur within the first 3 years, although recurrences 10 years postoperatively have been reported. 9,23 Long-term follow-up is recommended given that recurrences can occur after prolonged periods of time.…”

A sinonasal inverted papilloma: an evaluation of 38 cases at a single center

“…[20] Human papilloma virüsün varlığı ve p53 aşırı ekspresyonu inverted papillomda malign dönü-şümün göstergesi olabilir. [21] Ancak p53 aşırı ekspresyonunun genellikle HPV negatif olgularda görüldüğü belirtilmiştir. [22] Sonuç olarak, inverted papillom, tek taraflı nazal polipozise benzer semptomlar veren, benign bir tümör-dür.…”