Skull Base Inverted Papilloma: A Comprehensive Review

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.

Incidence of Various Benign Mass Lesions of the Nose in 2015: A Retrospective Study

“…8 In this study, there were 6 cases of Inverted papilloma noted which constituted 18.75% of all lesions in the nose other than Nasal polyposis.…”

Sinonasal Mass - A Diverse Clinicopathological Entity – An Experience in a Tertiary Care Centre in the North Eastern India

“…14 It is important to differentiate these lesions from those arising from the nasal bones or the maxilla which are primarily bony lesions and warrant a different surgical approach. 15 Inverted papilloma constitutes 0.4% to 4% of all sinonasal tumours 16,17 and in studies on Indian population inverted papilloma comprised nearly 6% of all sinonasal tumours. 3,4 Though rarely these tumours may be bilateral, inverted papilloma tumours should always be suspected in case of unilateral nasal mass in patients above 40 years age.…”

Low CT Attenuation Values of Sinonasal Benign Tumours Relative to the Brainstem Identify Schwannomas

“…IP appears as a solid mass with a relatively irregular surface and has a histologically marked patchy squamous metaplasia of the surface epithelium enclosed by a basement membrane. Calcification and focal hyperostosis, which are associated with high density on CT, are sometimes observed at the site of tumour origin [22]. In addition, in contrast to the schwannoma, regressive changes such as cystic degeneration, lipidisation, and necrosis with focal thrombosis are uncommon features [23,24].…”