Inverted papilloma: A report of 112 cases

Abstract

Inverted papilloma is a benign sinonasal tumor which is locally aggressive and has a significant malignant potential. This report updates the experience of the two senior authors, who have treated 112 patients with inverted papilloma at the Mount Sinai Medical Center over a 20-year period. As clinical examination often underestimates tumor extent, preoperative radiographic assessment is of paramount importance in guiding selection of surgical therapy. Complete en bloc excision via lateral rhinotomy and medial maxillectomy was the method of treatment in the majority of patients (84%). In selected patients with limited disease, or in patients who refused en bloc excision, conservative therapy employing intranasal or transantral ethmoidectomy was performed. The recurrence rates for the two groups were 14% and 20%, respectively. Recurrent disease developed throughout the paranasal sinuses, with the maxillary antrum and ethmoid labyrinth constituting the major sites. In two patients presenting with anterior skull base erosion, craniofacial resection was undertaken to eradicate disease. The latter cases underscore the aggressive nature of the tumor if left untreated. The overall rate of squamous carcinoma in this series was 5%. Given the predilection for local recurrence, multicentricity, and the possibility of malignancy, the authors continue to recommend lateral rhinotomy and medial maxillectomy as the standard therapy for the majority of cases. Management principles as well as a review of the literature are discussed.

Treatment outcomes of primary and recurrent inverted papilloma: an analysis of 96 cases

“…Inverted papilloma is known to have a peak incidence in patients during their fth to seventh decades, [1][2][3]12 and our results support these reports. There were no patients under the age of 30 and especially no patients of paediatric age.…”

“…As other authors have repeatedly shown, 1,5,7,12,13 our series indicates that aggressive surgical procedure can reduce the recurrence rate of inverted papilloma. Our conservative-treatment group showed a somewhat higher recurrence rate (33.9 per cent) when compared with other reported conservative-treatment groups (around 18 per cent).…”

“…1 Its aetiology and pathogenesis are still uncertain. Suggested aetiologies are viral infections, smoking, allergy, chronic in ammations and occupational exposures.…”

Schneiderian Papillomas and Nonsalivary Glandular Neoplasms of the Head and Neck

“…Inverted papillomas (IP) are two to five times more common in males and are found primarily in the 40 -70-year age group (2,3,8,14,15,(23)(24)(25)(26)(27)(28)(29)(30). The 6-year-old boy included in the series of Eavey (31) is one of the youngest patients yet described with this papilloma.…”

Fascin Over Expression is Associated with Dysplastic Changes in Sinonasal Inverted Papillomas: A Study of 47 Cases

“…Sinonasal IP comprises 0.5-4% of all nasal cavity and paranasal tumors, and accounts for approximately 10% of all squamous cell carcinoma (SCC) cases [1,2]. About 40% of patients with SCC-ex-IP will die of the disease within 3 years [3], yet its etiology is still not fully understood.…”