Squamous cell carcinoma arising in inverted papilloma

Abstract

A retrospective review of all cases of inverted papilloma at the University of Michigan from 1975 to 1992 revealed 51 cases of inverted papilloma. Of these, 14 (27%) had an associated squamous cell carcinoma (SCC). Eight (16%) were metachronous and 6 (11%) were synchronous. At a mean follow-up of 53 months, the disease-free survival of patients with carcinoma limited to the nasal cavity and paranasal sinuses was 57% (4/7) compared to 14% (1/7) of those patients presenting with disease extending beyond the nasal cavity and paranasal sinuses. The data also support the lateral rhinotomy approach with medial maxillectomy and ethmoidectomy as a minimum procedure followed by postoperative radiation therapy. The mean interval between the diagnosis of inverted papilloma and development of SCC was 63 months (range, 6 months to 13 years). Therefore, long-term follow-up with clinical examination and computed tomography (CT) scan is indicated for all patients with inverted papilloma.

Sinonasal Inverted Papilloma: Value of Convoluted Cerebriform Pattern on MR Imaging

“…3,7,[9][10][11] SCC is the most commonly associated malignant tumor. The carcinoma may actually arise within the IP or it may merely be associated with a histologically bland IP.…”

“…1,2 Although benign, it has a known propensity for a high rate of recurrence, local aggressiveness, multicentricity, and association with synchronous or metachronous squamous cell carcinoma (SCC). [3][4][5][6][7][8][9][10][11][12] Although CT and MR imaging are useful for preoperative assessment of sinonasal IP, differentiation of IP from other malignant sinonasal tumors is often difficult because of a significant overlap of the imaging features. [13][14][15][16][17][18][19] Barnes et al 20 described a distinctive gross mucosal morphology of IP, a so-called convoluted cerebriform pattern (CCP), which can be reflected on MR imaging by the characteristic alternating hypointense and hyperintense bands on T2-weighted and contrast-enhanced T1-weighted images, as reported by Ojiri et al 17 and supported by Maroldi et al 19 years later.…”

Inverted papilloma of paranasal sinuses

“…0.38 cases/million persons/year (Buchwald et al, 2001). The frequency of carcinoma in patients with IP is reported to be 1-53% (Hyams, 1971;Calcaterra et al, 1980;Lawson et al, 1989;Myers et al, 1990;Dolgin et al, 1992;Lesperance and Esclamado, 1995;Lawson et al, 1995;Peter and Grossenbacher, 1997). This considerable variation results from different follow-up periods and cohort sizes (Arndt et al, 1994).…”

“…There are many reports of a change from primarily benign IP to carcinoma in situ and to invasive carcinoma (Marcial-Rojas and De Leon, 1963;Mabery et al, 1965). Patients with carcinoma in IP are older than those IP patients without carcinoma (Myers et al, 1981;Christensen and Smith, 1986; Lesperance and Esclamado, 1995) and predominantly male (Lesperance and Esclamado, 1995;Buchwald et al, 1995b).…”

“…Some authors recommend follow-up CT scans after surgery (Lesperance and Esclamado, 1995). MR imaging has also been suggested as a follow-up technique to discriminate recurrent tumour from postoperative change and to identify optimum sites for control biopsy (Lai et al, 1999;Petit et al, 2000).…”