Das invertierte Papillom – eine seltene Ursache der nasalen Obstruktion

Intracranial extension of Schneiderian inverted papilloma: a case report and literature review

“…When the tumor reaches a grotesque size, it can cause nasal congestion, posterior nasal drip, epistaxis, hyposmia or anosmia, frontal headaches, epiphora, proptosis, diplopia, facial numbness and swelling. Pain and epistaxis associated with IP are rare, but they may indicate secondary infection or malignant changes of the lesion [2], [3], [4], [5], [14], [15], [20], [21]. These symptoms overlap with a myriad of other conditions, such as allergy, chronic rhinosinusitis and migraine [14].…”

“…Differential diagnosis of IP includes antral choanal polyp, nasal cavity squamous polyp, allergic fungal sinusitis, fibrous dysplasia, giant cell granuloma, juvenile angiofibroma, nasal glioma, meningoencephalocele, mucocele, mucus retention cyst, Tornwaldt’s cyst, grossly enlarged adenoids, SCC, lymphoma, adenocarcinoma and esthesioneuroblastoma [5], [8], [21], [34]. It is generally accepted that unilateral tumor localization involving the lateral nasal wall and the middle meatus is a diagnostic clue to IP.…”

“…Administration of corticosteroid and antibiotics prior to CT imaging can reduce the inflammatory polyps and thereby decreases overestimation of the lesion. Alternatively, this drawback can be resolved by using magnetic resonance imaging (MRI): either T2-weighted images or T1-weighted images with contrast or both [4], [5], [6], [7], [15], [16], [19], [21], [29], [33], [35]. …”

“…Moreover, destruction of sinus walls is more difficult to recognize by MRI, compared to CT. To date, there has been no adequate evidence to prove that MRI is better than CT in identifying IP preoperatively. A combination of CT and MRI is usually recommended before treatment, although its cost-effective analysis remains unclear [2], [5], [8], [14], [15], [19], [21], [26], [33]. …”

“…The tumor may extend beyond the nasal fossa and paranasal sinuses into the nasopharynx, pterygoid fossa, nasolacrimal duct, retrobulbar region and brain in descending order of frequency. Despite being benign, 3 typical characteristics of this tumor include its relatively high recurrence rate, local aggressiveness and potential for malignant transformation: atypia, dysplasia, carcinoma in situ , and frank squamous cell carcinoma (SCC) [1], [2], [3], [4], [5], [7], [8], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28]. …”