Inverted Sinonasal Papilloma Involving the Middle Ear with Evidence of Squamous Cell Carcinoma

Abstract

Inverted papilloma is an uncommon benign epithelial tumor that typically affects the nasal cavity and originates from the lateral sinonasal wall. Inverted papilloma occurring in the middle ear is an even more rare and aggressive condition. We describe a case of a 76-year-old man who was treated for isolated sinonasal inverted papilloma and after 20 months he was found to have a recurrence in the nasal cavity with middle ear involvement and malignant changes consistent with nonkeratinizing squamous cell carcinoma arising from inverted papilloma. Several surgical procedures were required to remove the tumor along with radiation therapy postoperatively.

Inverted Papilloma of the Middle Ear: Two New Cases and Systematic Review

“…Unlike sinonasal IPs, the association of HPV with IPs of the middle ear is unclear. The rate of HPV co-infection in patients with middle ear IPs is 14–35% [ 7 , 9 ]. Coca-Pelaz et al, postulates that the HPV infection rate can vary even more, from 0–85% [ 6 ].…”

“…Of the 20 cases, only 35% (n = 7) indicated that the patient was positive for HPV infection. Alghamdi et al suggest that HPV infection should play a role in the development of middle ear IPs due to the relationship of HPV to sinonasal IPs [ 9 ]. Thus, vaccination against HPV may be protective in patients prone to developing recurrent sinonasal or middle ear IPs.…”