Schneiderian Papillomas and Carcinomas: A Review

Abstract

The ectodermally derived Schneiderian mucosa gives rise to an extremely varied collection of benign and malignant neoplasms. Prototypical of these are the Schneiderian papillomas (inverted, fungiform, and cylindrical cell) and their malignant counterparts. Human papilloma virus (HPV) is currently the leading candidate as a cofactor in the pathogenesis of the papillomas. Carcinomas arise in association with the papillomas in about a 10% frequency. The carcinomas may be synchronous or metachronous. Recurrences of the papillomas are the bane of surgeons. The magnitude of the recurrences is directly proportional to the completeness of removal with the best results obtained by techniques that afford the best operative exposure. A comparison of results by different surgical procedures is presented. Histologic features sought to predict recurrences or malignant transformation have, by and large, not been helpful. Keratinization and hyperkeratosis in papillomas, however, are suggested to be sufficiently ominous as to warrant further study.

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.…”

Detection of human papillomavirus DNA in oral inverted ductal papillomas

“…Methods: Six cases were retrieved from archival material and paraffin wax blocks were submitted for the detection of HPV DNA by means of ISH. A wide spectrum probe for HPV subtypes 6,11,16,18, 31, 33, 45, 51, and 52 was used initially. Cases that were positive using this wide spectrum probe were further subtyped using HPV type specific probes (6/11, 16/18, and 31/33).…”

Epigenetic events underlie the pathogenesis of sinonasal papillomas

“…Recurrence rates for inverted papillomas range from 6 to 33% and malignant transformation occurs in 7-10% of cases. 2,21 Endophytic sinonasal papillomas, comprising inverted papillomas and cylindrical cell papillomas according to the World Health Organization classification, show malignant progression in up to 25% of cases. 22 The exact nature and biological evolution of sinonasal papillomas is not well known.…”

“…Inverted papillomas are the most commonly occurring sinonasal papillomas followed by exophytic. 2 Inverted papillomas arise from the lateral wall of the nose and paranasal sinuses and are associated with invasive squamous cell carcinoma (SCC). Its surface epithelium invaginates into the underlying stroma (Figure 1a), thus the name inverted (endophytic) papilloma.…”