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Li Y, Ma D. Bilateral sinonasal inverted papillomas originating from both sides of the frontal sinus and the left lamina papyracea: A case report. Medicine (Baltimore) 2024; 103:e37703. [PMID: 38608083 PMCID: PMC11018199 DOI: 10.1097/md.0000000000037703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/04/2024] [Indexed: 04/14/2024] Open
Abstract
RATIONALE The present investigation documented a case of bilateral sinonasal inverted papilloma (SNIP) that arose from both sides of the frontal sinus and ethmoid sinus. The occurrence of bilateral involvement of the nasal cavities and frontal sinus is rather infrequent. PATIENT CONCERNS Informed consent was obtained from the patient. DIAGNOSIS Bilateral SNIP. INTERVENTIONS The tumor was completely removed by Draf III endoscopic resection complemented by an external eyebrow arch approach, and the postoperative recovery was uneventful. OUTCOMES The purpose of this paper is to present a comprehensive reference for the management of bilateral SNIP that affects the frontal sinuses. LESSONS This study addresses the staging and surgical management of bilateral SNIP, along with a review of the factors contributing to its recurrence. The recommended treatment method involves applying the Draf III technique combined with an external nasal approach.
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Affiliation(s)
- Yang Li
- School of Clinical Medicine, Jining Medical University, Shandong, Jining, China
| | - Dengdian Ma
- Department of ENT, Affiliated Hospital of Jining Medical University, Shandong, Jining, China
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Russo C, Elefante A, Romano A, Cama A, Erra M, Ugga L, Brunetti L, Motta G, Califano L, Iengo M, Cantone E. A multimodal diagnostic approach to inverted papilloma: Proposal of a novel diagnostic flow-chart. Curr Probl Diagn Radiol 2020; 50:499-504. [PMID: 32540138 DOI: 10.1067/j.cpradiol.2020.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 03/28/2020] [Accepted: 04/14/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Inverted papilloma (IP) is a tumor usually arising from sinonasal cavities, with tendency for recurrence and possible malignant transformation. Along with endoscopy, computed tomography (CT) and magnetic resonance imaging (MRI) play a crucial role in defining preoperative staging, tumor origin, and possible differential diagnosis, with significant repercussions on therapeutic planning. However, at present no consensus has been reached concerning IP diagnostic workup. Aim of this study is to assess CT and MRI sensitivity and specificity in identifying IP imaging hallmarks, evaluating their global diagnostic accuracy in order to define a novel diagnostic flowchart. METHODS We retrospectively analyzed multimodal imaging of patients with histologically confirmed IP and mimics. Two neuroradiologists in consensus retrospectively rated the presence of typical imaging features of IP, both on CT and MRI scans. Sensitivity, specificity and diagnostic accuracy were assessed for both the techniques. Final results were expressed as ROC curves and relative areas under the curve (AUC). RESULTS The AUC considering CT parameters were 0.42, whereas the AUC considering MRI parameters were 0.54. Combining the 2 techniques and limiting the evaluation to the most distinctive features such as focal hyperostosis and CCP, the AUC was 0.79. CONCLUSION MRI can provide better tissue characterization and higher diagnostic accuracy in case of suspected IP, whereas CT is more useful in determining bony involvement. Here we propose a possible diagnostic flowchart for IP, based on the assumption that the combination of the imaging techniques allows to optimize the clinical assessment and the subsequent therapeutic planning.
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Affiliation(s)
- Camilla Russo
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy.
| | - Andrea Elefante
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy
| | - Antonio Romano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences - Division of Maxillofacial Surgery, University "Federico II", Naples, Italy
| | - Antonia Cama
- Department of Neurosciences, Reproductive and Odontostomatological Sciences - Division of Maxillofacial Surgery, University "Federico II", Naples, Italy
| | - Maurizio Erra
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy
| | - Lisa Brunetti
- Department of Radiology, Università Vita-Salute San Raffaele, Milano, Italy
| | - Gaetano Motta
- Otorhinolaryngology, Head and Neck Surgery Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Luigi Califano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences - Division of Maxillofacial Surgery, University "Federico II", Naples, Italy
| | - Maurizio Iengo
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - ENT section, University "Federico II", Naples, Italy
| | - Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - ENT section, University "Federico II", Naples, Italy
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Al Momen A, Alenzi HL, Al Eid M. Bilateral simultaneous sino-nasal inverted papilloma; A report of two cases and literature review. Int J Surg Case Rep 2020; 67:71-75. [PMID: 32028092 PMCID: PMC7005342 DOI: 10.1016/j.ijscr.2019.12.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/15/2019] [Accepted: 12/20/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction Inverted Papilloma is a benign sinonasal tumor with a high recurrence rate and potential for malignant transformation, it typically presents as an obstructing unilateral nasal mass, atypical presentations include bilateral involvement which occurs in up to 5 % of cases. Case presentation Here we present two different cases of bilateral inverted papilloma, both presented complaining of bilateral nasal obstruction, the second case also had associated nasal polyposis and history of multiple previous endoscopic sinus surgeries, both cases were managed with endoscopic medial maxillectomy and tumor removal, with no signs of recurrence on follow up. Conclusion Bilateral involvement is an uncommon, atypical presentation of inverted papilloma, endoscopic surgery is a safe, reliable approach and it is the mainstay of treatment, regular endoscopic and clinical follow up is important for detection of recurrence.
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Affiliation(s)
- Ali Al Momen
- Consultant ENT, Rhinology and Skull Base Surgery at King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | | | - Mohammad Al Eid
- ENT Resident, Saudi Commission of Health Specialties Eastern Province Program, Saudi Arabia
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Akkari M, Lassave J, Mura T, Gascou G, Pierre G, Cartier C, Garrel R, Crampette L. Atypical presentations of sinonasal inverted papilloma: Surgical management and influence on the recurrence rate. Am J Rhinol Allergy 2016; 30:149-54. [PMID: 26980397 DOI: 10.2500/ajra.2016.30.4288] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sinonasal inverted papilloma (SNIP), classically, is a unilateral benign tumor of the nasal lateral wall. Numerous variations have been observed, depending on location, bilateral presentation, or association with nasal polyposis. OBJECTIVE The aim of this work was to describe atypical presentations of SNIPs with their management specificities and to assess their influence on the recurrence rate in a large case series. METHODS A retrospective single center study of 110 patients treated for SNIP. Atypical inverted papillomas were identified according to the following criteria: (1) unusual location (frontal, posterior, anterior), (2) bilateral involvement, and (3) association with nasal polyposis. Surgical management was detailed, and the influence of each atypical group on recurrence was assessed by using Kaplan-Meier survival curves and the log-rank test. RESULTS Distribution of atypical presentations was as follows: frontal sinus localization (10.9%); posterior localization, including sphenoid sinus (9%); nasal anterior localization (3.6%); bilateral involvement (3.6%); and nasal polyposis association (10%). The surgical approach was endoscopic (74.5%), external (5.5%), or combined endoscopic and external (20%). Except for nasal anterior localization, all the groups were associated with a higher recurrence rate, without reaching statistical significance. CONCLUSION Recurrence rates for these atypical presentations arise from their specific surgical challenges. The choice of the surgical technique is guided by tumor location and extension, and by the surgeon's experience; the main objective is a complete resection. The endoscopic endonasal approach is the most frequent procedure.
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Affiliation(s)
- Mohamed Akkari
- Department of Ear, Nose and Throat and Head and Neck Surgery, University Hospital Gui de Chauliac, University of Montpellier, Montpellier, France
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Gomes EF. Endoscopic surgery to treat inverted papilloma: which are the limits? Braz J Otorhinolaryngol 2013; 79:275. [PMID: 23743740 PMCID: PMC9443919 DOI: 10.5935/1808-8694.20130050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Caparroz FDA, Gregório LL, Kosugi EM. Evolution of endoscopic surgery in the treatment of inverted papilloma. Braz J Otorhinolaryngol 2013; 79:13-7. [PMID: 23503901 PMCID: PMC9450791 DOI: 10.5935/1808-8694.20130003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 10/06/2012] [Indexed: 11/20/2022] Open
Abstract
Inverted papilloma (IP) has several treatment avenues. The endoscopic approach in the last decade has proven to be a good option over the traditional approach. Objective Describe the epidemiological profile of patients with inverted Papilloma, describe our experience on managing this tumor and compare our data with the literature. Study Design: Cross-sectional, historical cohort. Method Retrospective study of medical records of 17 patients treated for histopathologically-confirmed inverted papilloma between 2005 and 2011. We assessed patients age, gender, tumor side, symptoms, diagnosis, comorbidities and habits, Krouse staging, surgical approach, intraoperative and postoperative, and malignant postoperative recurrence and also the correlation between recurrence with preoperative staging, the surgical approach used, and the presence of malignancy. Results Five (29.41%) patients were classified as Krouse stage T2, 9 (52.94%) as T3 and 3 (17.65%) as T4. Three (17.65%) patients had malignancy and the recurrence rate was 23.5% (4 pacients). Eleven patients (64.70%) underwent endoscopic approach, 3 (17.6%) the combined aprroach (endoscopic assisted) and 3 (17.6%) external approach. Conclusion The endoscopic approach is currently becoming a method not only effective but also safe for the treatment of more advanced stages of IP.
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Affiliation(s)
- Fábio de Azevedo Caparroz
- Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
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Wassef SN, Batra PS, Barnett S. Skull base inverted papilloma: a comprehensive review. ISRN SURGERY 2012; 2012:175903. [PMID: 23346418 PMCID: PMC3549337 DOI: 10.5402/2012/175903] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 10/17/2012] [Indexed: 11/23/2022]
Abstract
Skull base inverted papilloma (IP) is an unusual entity for many neurosurgeons. IP is renowned for its high rate of recurrence, its ability to cause local destruction, and its association with malignancy. This paper is a comprehensive review of the reports, studies, and reviews published in the current biomedical literature from 1947 to September 2010 and synthesize this information to focus on its potential invasion to the base of the skull and possible intradural extension. The objective is to familiarize the clinician with the different aspects of this unusual disease. The role of modern diagnostic tools in medical imaging in order to assess clearly the limits of the tumors and to enhance the efficiency and the safety in the choice of a surgical approach is pointed out. The treatment guidelines for IP have undergone a complex evolution that continues today. Radical excision of the tumour is technically difficult and often incomplete. Successful management of IP requires resection of the affected mucosa which could be achieved with open surgery, endoscopic, or combined approach. Radio and chemotherapy were used for certain indications. More optimally research would be a multicenter randomized trials with large size cohorts.
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Affiliation(s)
- Shafik N Wassef
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA ; McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada H3A 2B4 ; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada H3A 2B4
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Halimi M, Aghbali A, Emamverdizadeh P, Talesh KT. Inverted papilloma of the palate with malignant transformation. J Oral Maxillofac Pathol 2012; 16:291-3. [PMID: 22923908 PMCID: PMC3424952 DOI: 10.4103/0973-029x.99093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The inverted papilloma is a unilateral sinonasal benign tumor which is characterized by aggressive local invasion, high recurrence rate, and transformation into malignancy. The etiology of inverted papilloma is still unknown. Possible causes include allergy, chronic sinusitis, occupational exposure to dusts and aerosols, tobacco, and viral infections. Treatment is complete surgical excision and close postoperative follow-up is necessary. Here we report a case of inverted papilloma arising from the hard palate with malignant transformation in a 41-year-old female. Clinical and histological features and treatment are discussed with the review of literature.
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Affiliation(s)
- Monireh Halimi
- Department of Pathology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Darwish A, Al-Abdulla A. Cylindrical Cell Papilloma (Oncocytic Schneiderian Papilloma): Clinicopathological Study of Five Cases. Oman Med J 2012; 27:e039. [PMID: 28861190 DOI: 10.5001/omj.2012.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To study the clinicopathological findings of cylindrical cell papilloma (oncocytic schneiderian papilloma) diagnosed among patients at Bahrain Defense Force Hospital with review of literature. METHODS All cases of cylindrical cell papilloma were retrieved from the pathology register from 2006-2010. The medical records of the cases were studied for age, sex, clinical presentation, and imaging reports along with the histopathological findings. RESULTS Five cases were found and showed male to female ratio 4:1. Their ages were between 36-71 years with average age of 55 years. The main symptom found was unilateral nasal obstruction mainly involving the left side. All papillomas were removed by endoscopic sinus surgery. Four patients had regular followup with complete recovery, while only one case was lost for followup. CONCLUSION Cylindrical cell papilloma is a variant of sinonasal schneiderian papilloma. Although most are benign complete excision is the treatment of choice to prevent tumour recurrence as a proportion exhibit unpredictable biological behavior. This study is an important reminder for both clinicians and pathologists to recognize this tumor and to differentiate it from other tumours and rhinosporidiosis. Regular followup is an important strategy for complete recovery and tumour-free surveillance.
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Affiliation(s)
- Abdulla Darwish
- Pathology Department, Bahrain Defence Force Medical Services Kingdom of Bahrain
| | - Amal Al-Abdulla
- Pathology and ENT Departments, Bahrain Defence Force Medical Services Kingdom of Bahrain
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Pitak-Arnnop P, Bertolini J, Dhanuthai K, Hendricks J, Hemprich A, Pausch NC. Intracranial extension of Schneiderian inverted papilloma: a case report and literature review. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2012; 10:Doc12. [PMID: 22737105 PMCID: PMC3380239 DOI: 10.3205/000163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Indexed: 11/30/2022]
Abstract
Inverted papilloma is an uncommon primary nasal tumor. Despite its benign nature, this tumor represents three typical characteristics: a high propensity of recurrence, local aggressiveness and association with malignancy. Inverted papilloma can reduce the patient’s quality of life due to compromised nasal function, extension to the orbit and brain. The authors reported the unusual case of a 72-year-old male patient with inverted papilloma, which fatally extended to the intracranial temporal fossa after multiple recurrences. To the authors’ knowledge, this is the twelfth case in the literature of inverted papilla extending into the temporal fossa. The current and pertinent literature in English, French and German was reviewed, and an algorithm for managing inverted papilloma was also proposed.
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Affiliation(s)
- Poramate Pitak-Arnnop
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, University Hospital of Leipzig, Leipzig, Germany.
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Recurrent inverted papilloma with intracranial and temporal fossa involvement: A case report and review of the literature. Cancer Radiother 2010; 14:202-5. [PMID: 20418144 DOI: 10.1016/j.canrad.2010.01.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Revised: 01/18/2010] [Accepted: 01/20/2010] [Indexed: 10/19/2022]
Abstract
Inverted papilloma (IP) is a rare nasosinusal benign tumour, with epithelium surface inversion to inside the stroma. Extension to intracranial temporal fossa and middle ear has been reported in few cases in the literature. This involvement may be derived from either direct extension from sinonasal cavity via the Eustachian tube or primary middle ear involvement secondary to metaplastic changes of the middle ear mucosa. Here, we report a case of inverted papilloma in a male patient, with multiple recurrences, middle ear and intracranial involvement into the temporal fossa with posterior development of malignancy. This patient had received multiple surgeries and radiotherapy but despite of that, his disease recurred several times. As a conclusion, inverted papilloma is a benign tumour with an aggressive course, tendency to recurrence and progression to malignancy. Intracranial and temporal fossa involvements are rare and the treatment depends of the symptoms and the severity of the disease.
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Sinonasal inverted papilloma: narrative review. The Journal of Laryngology & Otology 2010; 124:705-15. [PMID: 20388243 DOI: 10.1017/s0022215110000599] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Sinonasal inverted papilloma is a benign condition with the potential for recurrence and malignant change. Over the past few decades, numerous studies and reviews have addressed different aspects of this condition. OBJECTIVE To amalgamate the current literature on inverted papilloma, in order to review the evidence and consider the gaps in current knowledge. METHODS Retrospective, narrative review. RESULTS The reported incidence of inverted papilloma varies between centres and is affected by selection bias. The exact aetiology of inverted papilloma is not fully understood. Currently, there is no reliable histological or biological marker to predict the probability of recurrence or malignant transformation. There is no universally accepted staging system available for sinonasal inverted papilloma. Complete surgical removal of the tumour is the mainstay of treatment, but the method of choice depends on the extent of the disease, the skill of the surgeon and the technology available. CONCLUSION In order to compare different studies and to enable meta-analysis of the literature, there should be a universally accepted staging and classification system for sinonasal inverted papilloma. Further research on the aetiology of sinonasal inverted papilloma, and on biological markers for its recurrence and malignant transformation, is required. To enable meaningful future research, we would encourage multicentre participation with a consensus on management.
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