Inverted Papilloma in a 10-Year-Old Boy

Abstract

\s=b\Inverted nasal papillomas are rare tumors in children. Four large series include only a single patient (of a total of 269) younger than 20 years. We report the occurrence of an inverted nasal papilloma in a 10-year-old boy; this tumor exhibited clinical and histopathologic features identical to those of similar neoplasms in adults. Inverted papillomas in children should be treated by wide local excision, usually using a lateral rhinotomy approach. The rationale for such aggressive surgery is based on the high rate of recurrence (25% to 75%) and a propensity for the development of carcinomas (5% to 15%) as associated lesions. (Arch Otolaryngol 1984;110:813-815) The inverted papilloma is an unusual benign tumor of the nasal cavity and paranasal sinuses. It is about one-twenty-fifth as frequent as ordinary nasal polyps1 and is uncommon in children.2-3 Hyams," in a review of 149 cases from the Registry of Otolaryngic Pathology of the Armed Forces Institute of Pathology, found no examples of this tumor in persons younger than 20 years old. Snyder and Perzin1 (39 cases) had no patients younger than 30 years old, while the youngest patient (of 24) Reprints not available. described by Vrabec5 was 35 years old. Suh et al,6 reporting on a 30-year experience at the Mayo Clinic, noted one patient (of 57) in the 11-to 20-year age group, but no others younger than 30 years old. We report the occurrence of an inverted papilloma in a 10-year-old boy; this lesion exhibited clinical and histopathologic features identical to those of similar tumors in adults. REPORT OF A CASEA 10-year-ll-month-old boy was seen with right-sided nasal obstruction of sev¬ eral months' duration. He had experienced difficulty in breathing with his mouth closed, as well as some sneezing and occa¬ sional headaches. Right-sided nasal drain¬ age and intermittent epistaxis had also been noted, which had increased when he took aspirin. He had no other otorhinological symptoms. His primary care physician had referred him for otorhinologic exami¬ nation with a provisional diagnosis of nasal polyps. Medical (including allergic) history was noncontributory; the patient specifically denied previous nasal disease or surgery. A family history was unavail¬ able because the child was adopted. He used neither alcohol nor tobacco.Otorhinological examination showed complete occlusion of the right nasal cavity by a red-tan, multilobulated, somewhat granular tumor that arose from the right lateral nasal wall and floor. The nasal septum was deviated to the left. Multiple roentgenograms and tomograms of the paranasal sinuses disclosed a large poly¬ poid mass arising from the anterior aspect of the right inferior turbinate (Fig 1). This was associated with soft-tissue swelling in both maxillary sinuses and opacification of the left ethmoid, sphenoid, and frontal sinuses. No osseous expansion, erosion, or loss was present. A biopsy of the tumor was interpreted as epithelial papilloma containing thickened, undulating epitheli¬ um.The tumor was removed via an en-bloc exc...

Recurrent inverted papilloma of a pediatric patient: Clinico-radiological consideratıons

“…Intranasal soft-tissue lesions which are seen in pediatric population include nasal polyps, antrochoanal polyps, angiofibroma, fibrous histiocytomas, meningiomas, neurofibromas, hemangiomas, pyogenic granulomas, glioma, meningoencephaloceles and rarely rabdomyosarcomas [1,3,4,6,[12][13][14]. Table 1 shows the differential diagnosis of intranasal soft tissue lesions (Table 1) [1,15,16].…”

“…Table 1 shows the differential diagnosis of intranasal soft tissue lesions (Table 1) [1,15,16]. Its gross examination, nasal polyp and inverted papilloma may not be differentiated [1].…”

“…Table 1 shows the differential diagnosis of intranasal soft tissue lesions (Table 1) [1,15,16]. Its gross examination, nasal polyp and inverted papilloma may not be differentiated [1]. The preoperative evaluation is essential in assessing the extent of IP and endoscopy with biopsy, CT and in selected cases magnetic resonance imaging (MRI) is helpful in making a management plan [8,10,17].…”

“…However, middle meatal mass and opacification of ipsilateral maxillary sinus and of the other paranasal sinuses may be suggested as valuable for IP diagnosis [1,8]. The main CT feature of IP is a middle meatal mass extent into maxillary sinus and this characteristic CT view has been named as ''Continent of Africa''.…”

Valoración diagnóstica correlativa de los Papilomas Rinosinusales a través de una Escala de Índice de Sospecha

“…A pesar de ser lesiones raras en adultos jóvenes y mucho mas raras en adolescentes y niños, la literatura la ha reportado en pacientes entre los rangos de edad, comprendidos entre los 6 a los 90 años (6,10). Los hombres se ven afectados 4 veces más que las mujeres (11).…”