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

Abstract

This series was undertaken to investigate the incidence of associated polyps and the recurrence rates of inverted papillomas with, or without, malignancies, as well as the treatment outcomes of the recurred cases.A retrospective study evaluating the pathology, associated polyps, types of operation, recurrence rate after original operation, and surgical outcomes of recurred cases was conducted upon 96 patients diagnosed with inverted papilloma.The overall malignancy rate was 11.5 per cent with synchronous tumours accounting for 9.4 per cent and metachronous for 2.1 per cent. In ammatory polyps were found in association with inverted papilloma in 21.9 per cent. In cases without malignancies, the recurrence rate after the original conservative procedure was 33.9 per cent, compared to 14.3 per cent after a medial maxillectomy. In cases with malignancies, the recurrence rate after the original surgical procedure was 22.2 per cent.Our study indicates that more aggressive and bolder surgical resection of inverted papilloma should be undertaken as a primary treatment method, or as a treatment for recurrent cases to reduce the recurrence rate of inverted papilloma with, or without, malignancy.

Clinical Outcomes of Endoscopic and Open Resection of Recurrent Sinonasal Inverted Papilloma

“…However, the differences in recurrence rates between secondary and primary resection in the study of Tufano et al and Han et al were not statistically significant. Yoon et al 17 reported that the recurrence rates after secondary resection (18%) were lower than that after primary resection (27%). Lee et al reported 3 (17.6%) of 17 recurrent sinonasal inverted papillomas after secondary endoscopic surgery observed to have local residual disease and required revision surgery.…”

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

“…Malignant transformation and concurrent malignant disease is well recognized in this benign sinonasal tumor with rates in the literature ranging from 6 to 14.5% [2,10,27]. The factors which are responsible for this malignant transformation are as yet not understood.…”

“…Inverted papilloma is a benign sinonasal tumor which is locally aggressive and has a well recognized malignant potential with a transformation rate often quoted in the literature in the region of 2.1-7% [1][2][3]. It has been documented across all ages and constitutes 0.5-4% of all sinonasal tumors [4].…”

Mitomycin C in the treatment of a Schneiderian (inverted) papilloma of the lacrimal sac

“…As a result of their aggressive nature, propensity to recur (10-33.9%), and malignant transformation (5-11.5%) The multilobulated papillary tissue removed during the second dacrocystorhinoplasty they should not be managed as benign [1,2]. Dacryocystectomy, with complete surgical excision of the tumour, is the preferred treatment [3].…”

“…We recognize that wide local excision prevents residual disease and recurrences in these tumours, however it is possible that MMC had a positive role in reducing the risk of further recurrence in this case. The majority of these tumours arise from the nasal and paranasal sinus mucosa [1,2], and presence in the lacrimal sac is commonly by extension from the primary site of origin; hence it may be that irrigation of the lacrimal system alone during the DCR is not adequate. Future studies would help to clarify if the use of MMC could be a promising adjunct to surgical excision in the treatment of nasolacrimal inverted papillomas.…”