Inverted Sinonasal Papilloma: Update and Literature Review
Issue: 2023 - Volume 21 [Issue 11]
Babatope Lanre Awosusi *
King Khalid Hospital, Almajma’ah, Saudi Arabia.
Adam Tolulope Rahman
King Salman Medical City Medina, Saudi Arabia.
*Author to whom correspondence should be addressed.
Inverted sinonasal papilloma is a benign neoplasm that usually affects the intra-nasal cavity and adjacent paranasal sinuses. Inverted papillomas have three unique features that distinguishes them from other sinonasal tumors including; a propensity for local destructive growth, a high rate of recurrence and risk of malignant transformation. The reported yearly incidence is about 0.6 to 1.5 cases per 100,000 people per year and they usually account for 0.5% to 4% of all nasal tumors. They occur at the following locations; both lateral nasal walls, ethmoidal cells, maxillary sinus, the frontal sinus, sphenoid sinuses and the nasal septum in decreasing order. It occurs most commonly in the fifth and sixth decades of life with a male-to-female ratio of 2-3:1. Inverted papilloma can arise from the entire Schneiderian membrane and molecular genetics have confirmed that it is an actual neoplasm that arises from a single progenitor cell. Most cases are diagnosed from clinical history and thorough physical examination. However, complete removal of all affected tissue with thorough histopathological evaluation is recommended to ensure a correct diagnosis. While there is yet no established pathognomonic histopathological feature to predict recurrence with all certainty, there is ongoing investigation for predictive markers of recurrence. Smoking seems to be a recognized risk factor for developing multiple recurrences and there is evidence that the presence of HPV serotypes 16 and 18 could be predictive of malignant transformation. The main aim of treatment is to achieve compete surgical resection and to prevent recurrence and malignant transformation. A period of clinical follow up is recommended after treatment. The aim of this review is to provide a comprehensive and updated overview of the clinical presentation, diagnosis, management and prognosis of this unique lesion.
Keywords: Inverted papilloma, sinonasal, squamous, schneiderian
How to Cite
Eggers G, Mühling J, Hassfeld S. Inverted papilloma of paranasal sinuses. J Cranio maxilla fac Surg 2007; 35:21–9.
Anari S, Carrie S. Sinonasal inverted papilloma: A narrative review. The Journal of Laryngology & Otology. 2010;124:705–715.
Vorasubin N, Vira D, Suh JD, Bhuta S, Wang MB. Schneiderian papillomas: comparative review of exophytic, oncocytic, and inverted types. Am J Rhinol Allergy. 2013;27(4):287–292.
Mohan S, Nair S, Sharma M, Nilakantan A, Malik A. Inverted papilloma of frontal sinus with intracranial extension. Med J Armed Forces India. 2015;71(1): S152–S155.
Krouse JH. Endoscopic treatment of inverted papilloma: safety and efficacy. Am J Otolaryngol. 2001;22:87–99.
Barnes L. Schneiderian papillomas and non-salivary glandular neoplasms of the head and neck. Mod Pathol. 2002;15(3): 279–297.
Dunbar NE, Segrin C. International scholarly research notices. ISRN Educ. 2012:1–9.
Xu B. Sinonasal papilloma.
Accessed September 7th, 2023.
Karkos PD, Fyrmpas G, Carrie SC, Swift AC. Endoscopic versus open surgical interventions for inverted nasal papilloma: a systematic review. Clin Otolaryngol 2006;31:499–503.
Syrja¨nen KJ. HPV infections in benign and malignant sinonasal lesions. J Clin Pathol 2003;56(3):174–181.
Wang M-J, Noel JE. Etiology of sinonasal inverted papilloma: a narrative review. World J Otorhinolaryngol Head Neck Surg. 2017;3(1):54–58.
Melroy CT, Senior BA. Benign sinonasal neoplasm: a focus on inverting papilloma. Otolaryngol Clin North Am 2006;39:601–17.
Ungari C. Management and treatment of sinonasal inverted papilloma. Ann Stomatol (Roma). 2015;6:87–90.
Budu V, Schnaider A, Bulescu I. Endoscopic approach of sinonasal inverted papilloma-our 15 years’ experience on 162 cases. Rom J Rhinol. 2015;5(17):31–36.
Syrja¨nen KJ HPV infections in benign and malignant sinonasal lesions. J Clin Pathol. 2003;56(3):174–181.
Wood JW, Casiano RR. Inverted papillomas and benign nonneoplastic lesions of the nasal cavity. Am J Rhinol Allergy. 2012;26(2):157-163.
Lane AP, Bolger WE. Endoscopic management of inverted papilloma. Curr Opin Otolaryngol Head Neck Surg 2006; 14:14–18.
Pou AM, Vrabec JT. Inverting papilloma of the temporal bone. Laryngoscope 2002; 112:140–2.
Busquets JM, Hwang PH. Endoscopic resection of sinonasal inverted papilloma: a meta-analysis. Otolaryngol Head Neck Surg. 2006;134:476–82.
Jardine AH, Davies GR, Birchall MA. Recurrence and malignant degeneration of 89 cases of inverted papilloma diagnosed in a non-tertiary referral population between 1975 and 1995: clinical predictors and p53 studies. Clin Otolaryngol Allied Sci. 2000; 25:363–9.
Katori H, Nozawa A, Tsukuda M. Histopathological parameters of recurrence and malignant transformation in sinonasal inverted papilloma. Acta Otolaryngol. 2006; 126:214–18.
Mumbuc S, Karakok M, Baglam T, Karatas E, Durucu C, Kibar Y. Immunohistochemical analysis of PCNA, Ki67 and p53 in nasal polyposis and sinonasal inverted papillomas. J Int Med Res. 2007;35:237–41.
Yasumatsu R, Nakashima T, Kuratomi Y, Hirakawa N, Azuma K, Tomita K et al. Serum squamous cell carcinoma antigen is a useful biologic marker in patients with inverted papillomas of the sinonasal tract. Cancer. 2002;94:152–8.
Wang AL, Liu HG, Zhang Y. Increased expression of fascin associated with malignant transformation of sinonasal inverted papilloma. Chin Med J (Engl). 2007;120:375–9.
Gaillard F, Yap J, Saber M, et al. Inverted papilloma. Reference article, Radiopaedia. org
(Accessed on 07 Sep 2023)
Kamath MP, Shenoy SV, Prasad V, Bhojwani K, Pai R, Mathew NM. Inverted papilloma of atypical origin with unusual extension into the oropharynx. J Cancer Res Ther. 2015;11(3):666.
Garcia AS, Bravo-Caldero´n DM, Ferreira MP, Oliveira DT. Squamous cell carcinoma arising from inverted Schneiderian papilloma: a case report with oral involvement. Case Rep Otolaryngol. 2014: 1–3.
Krouse JH. Development of a staging system for inverted papilloma. Laryngoscope. 2000;110(6):965–968.
Sauter A, Matharu R, Hörmann K, Naim R. Current advances in the basic research and clinical management of sinonasal inverted papilloma. Oncol Rep 2007;17: 495–504.
Mendenhall WM, Hinerman RW, Malyapa RS, Werning JW, Amdur RJ, Villaret DB et al. Inverted papilloma of the nasal cavity and paranasal sinuses. Am J Clin Oncol 2007;30:560–3.
Mirza S, Bradley PJ, Acharya A, Stacey M, Jones NS. Sinonasal inverted papillomas: recurrence, and synchronous and metachronous malignancy. J Laryngol Otol. 2007;121:857–64.
Kakkar A, Satapathy S, Sikka K, Tanwar P, Deo SV, Jain D. Evaluation of high-risk human papillomavirus in sinonasal papillomas and squamous cell carcinomas. Virchows Archiv. 2023:1-2.
Hebsgaard M, Erickson P, Ramberg I, von Buchwald C. Human Papillomavirus in Sinonasal Malignancies. Current Otorhinolaryngology Reports 2023;11:109 –116.
Lisan Q, Laccourreye O, Bonfils P. Sinonasal inverted papilloma: From diagnosis to treatment. European annals of otorhinolaryngology, head and neck diseases. 2016; 133(5): 337-41.
Udager AM. Histopathologic Diagnosis of Sinonasal Tumors: Challenges and the Importance of Establishing the Correct Diagnosis Current Otorhinolaryngology Reports Curr Otorhinolaryngol Rep. 2023; 1-8.