Artikel
Inverted sinonasal papillomas – a clinical and pathological study
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Autoren
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Viorel Nath
- HNO Klinik, DIAKO Krankenhaus, Bremen
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Csaba Huska
- Department of Pathology, University Hospital RWTH Aachen, Aachen
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Justus Ilgner
- Department of Oto-Rhino-Laryngology and Plastic Surgery, University Hospital RWTH, Aachen
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Yue-Shih Chen
- Department of Oto-Rhino-Laryngology and Plastic Surgery, University Hospital RWTH, Aachen
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Ercole Di Martino
- Department of Oto-Rhino-Laryngology and Plastic Surgery, DIAKO Hospital, Bremen
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Martin Westhofen
- Department of Oto-Rhino-Laryngology and Plastic Surgery, University Hospital RWTH, Aachen
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Ruth Knüchel–Clarke
- Department of Pathology, University Hospital RWTH Aachen, Aachen
| Veröffentlicht: | 22. April 2008 |
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Gliederung
Text
Introduction: Inverted papilloma is a relatively rare neoplasm, constituting up to 4% of all primary nasal tumors. Its etiology is unclear. Theories like viral infections, environmental carcinogens, proliferation of nasal polyps, allergy, chronic inflammation, have been raised.
Patients and Methods: Over a 6-year period twenty-two patients (7 women and 15 men) with histologically proven inverted sinonasal papilloma were analyzed retrospectively.
Because human papilloma viruses currently seem to be an important candidate as a cofactor in the pathogenesis of the inverted papilloma,we tried to identify the presence of viral DNA in the squamous metaplastic epithelium using PCR – ELISA technique.
Results: Histological examination revealed inverted papilloma with focal transformation to squamous cell carcinoma in three cases (13.6%).
In ten cases (45%) localized bone defects were found on the preoperative CT scans as well as intraoperatively.
Of the 15 samples with inverted papilloma, 8 were HPV DNA positive (≈50%).
Conclusions: IP’s of the nose and paranasal sinuses are locally aggressive, uncommon benign epithelial tumors that can mimic sinonasal malignant growth. Wide extent of the tumor and/or bone destruction cannot be taken as indicators for association with or transition to malignancy. Although its etiology is yet unclear, IP is most likely of heterogeneous origin, with HPV related and HPV non-related tumors.
