Malignant Transformation in a Case of Recurrent Sinonasal Inverted Papilloma

Abstract

Inverted papilloma or Ringertz tumour is an uncommon benign tumour that arises from the Schneiderian membrane of the ectoderm. It accounts for approximately 70% of all sinonasal papillomas and 0.5-4% of all sinonasal tract neoplasms. It often originates in the middle meatus of the lateral nasal wall and is well-known for its local invasiveness and high recurrence rate. Nasal obstruction, nasal bleeding, and diminished sense of smell are the most common symptoms. Here, the authors report a case of a 58-year-old male complaining of right nasal obstruction since 3 months. The patient had nasal growth for which he underwent nasal endoscopy. History revealed that he had similar growth on the left side, 10 years ago. A nasal endoscopic biopsy was performed and the histopathological examination showed an inverted growth pattern from the sinonasal papilloma. Surgical techniques must be extensively explored and customised, with enhanced radiological assessment of tumour borders, in order to adequately remove the tumour, since incomplete excision increases the risk of recurrence and malignant transformation of the residual disease.

Keywords

• nasal obstruction
• ringertz tumour
• sinonasal malignancy
• sinonasal tumour
• squamous cell carcinoma