FIGURE 4 - uploaded by Thiago de Santana Santos
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A. A view with small increase showing a papilliferous epithelial proliferation with central areas of edematous connective tissue (hematoxylin and eosin, x100); B. Hybridization in situ revealing positivity for HPV (original x400)
Source publication
Inverted Schneiderian papilloma (ISP) is a neoplasm of epithelial lining origin which arises in the respiratory mucosa that lines the nasal cavity and paranasal sinuses. The inverted Schneiderian papilloma frequently appears as a unilateral lesion in the nasal septum and extends secondarily to the nasal and paranasal sinuses. This paper reports an...
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OBJECTIVES
To evaluate the clinical presentation, treatment outcome and follow-up of all patients managed with sinonasal papillomas (SP), at a tertiary private otorhinolaryngology centre in Caracas (Venezuela).
MATERIAL AND METHODS
We reviewed 94 patients with SP that were treated at our otolaryngology center, from July 1st 1993 to June 31st 2015....
Citations
... Sinonasal inverted papilloma (SIP) usually affects men, with a male-to-female ratio of 4: 1, and normally occurs between the ages of 40 and 70 years; it is rarely observed during childhood and adolescence [9][10][11]. In descending order, the most commonly affected paranasal sinuses are the maxillary, ethmoidal, frontal, and sphenoidal; extension to the base of the skull is rare [12,13]. ...
... Orbital involvement occurs in about 9% of cases of advanced SIP [8]. However, there are no reports of cases of benign tumors that invaded the adjacent soft tissues [10,11]. ...
Patient: Male, 60-year-old
Final Diagnosis: Sinonasal inverted papilloma
Symptoms: Facial asymmetry • nasal obstruction • right hemiface proptosis
Medication: —
Clinical Procedure: —
Specialty: Dentistry • Pathology • Surgery
Objective
Rare disease
Background
Nasosinusal papilloma is a benign aggressive tumor. It usually occurs unilaterally in the nasal cavity and can extend to the sinuses. The diagnosis is made by the correlation of findings observed in tomographic and histo-pathological exams. The recommended treatment is surgical excision with clinical monitoring. Orbital involvement occurs in about 9% of cases of advanced SIP. However, there is no report of cases of a benign tumor that invaded the adjacent soft tissues. Therefore, our objective is to report an unusual case of SIP that bilaterally involved the nasal cavity and maxillary sinuses, and extended to involve the ethmoidal cells and sphenoid and frontal sinuses.
Case Report
In this article, we report an unusual presentation of sinonasal inverted papilloma (SIP) in a 60-year-old man. The tumor bilaterally involved the nasal cavity and maxillary sinuses and extended to involve the ethmoidal cells and the sphenoid and frontal sinuses, as well as the orbital cavity on the right side. An open surgical procedure was performed for complete removal of the lesion and follow-up with imaging exams.
Conclusions
The involvement of these structures is uncommon in SIP. This highlights the importance of this case report. Diagnosis and surgical treatment must be carefully planned. In this work, we describe all the steps that helped guide the choice of the best surgical technique to be performed and offer the best clinical follow-up.
... This report describes a very rare case of IP complicated by SCC, originating from the maxillary sinus, invading the nasal cavity, paranasal sinuses, orbital floor, and pterygopalatine fossa, causing bone destruction that leads to involvement of the oral cavity. To date, there have been only three reports of IP with involvement of the oral cavity in the literature [6][7][8], and one of these describes the concomitant presence of SCC [8]. ...
Inverted papilloma (IP) is a benign tumour characterized by the growth of epithelial cells downward into the underlying supportive tissue. The tumour derives from the lining mucosa of the nasal cavity and paranasal sinuses. IP typically arises as a unilateral lesion from the lateral wall of the nasal cavity and extends secondarily to the paranasal sinuses. The aggressive behaviour of IP causing local invasion, its tendency for local recurrence, and its propensity to be associated with carcinoma constitute serious complications. This paper describes a very rare case of IP associated with squamous cell carcinoma, extending into paranasal sinuses, causing destruction of the bony wall of maxillary sinus and involvement of the oral cavity.
... asymptomatic HpV infections in oral mucosa are not uncommon, observed in 11% of subjects. 15 Though HpV has been implicated in nasal and sinonasal inverted papillomas (nSips), 16 the exact role of HpV in the etiology and pathogenesis of oral inverted papilloma is equivocal. 14 The reported prevalence of HpV in normal mucosa varies depending on sample collection technique, age, sex, and HpV detection methods. ...
... 14,18 The clinical acquisition of a verrucous aspect and squamous metaplasia undergone by iSp in some situations lead to a diagnostic dilemma, as in our case, as the lesions are easily mistaken for verrucous carcinoma. 16,19 Treatment and recurrence Surgical removal is the treatment of choice for idpoc. no relapses or malignant transformation have been reported to date. ...
... no relapses or malignant transformation have been reported to date. 16,20 Our study is the first in literature to report recurrence of ipdoc. ...
... ISPs arise from a single progenitor cell which replicates hyperplastic endophytic epithelium (Eggers et al., 2007). As the cells invade the Schneiderian membrane it becomes inflamed, stimulating the formation of excess fibrous connective tissue and oedema (Piva et al., 2001;Wassef et al., 2012). The Schneiderian membrane, a source of osteoprogenitor cells, may also contribute to NBF if stimulated to produce osteoblasts (Srouji et al., 2009). ...
During the routine assessment of skeletal material unearthed from Middenbeemster, a post-Medieval (AD 17-19th century) cemetery in Northern Holland, an adult male with an unidentified choanal lesion was discovered. The affected individual was analysed macroscopically and via computer tomography. Based on the phenotypic and radiographic characteristics of the lesion, and after a comprehensive review of clinical literature, it was determined that the lesion was likely caused by an inverted Schneiderian papilloma (ISP), a benign but locally aggressive endophytic neoplasm histopathologically characterized by the inversion of the epithelium into the lamina propria (Schneiderian membrane) of the respiratory nasal mucosa. This study presents a detailed description of the pathophysiology and aetiology of ISPs, using both bioarchaeological and biomedical frameworks. Several differential diagnoses are discussed, with emphasis on the reasons for their rejection as the primary pathogenic mechanism(s). To the best of the authors' knowledge, this research is the first reported case of ISP within palaeopathology, which highlights the need to consider ISPs whenever slow-growing sinonasal neoplasms are suspected, as well as in cases that exhibit focal rhinitis.
... Papillomas are uncommon benign tumors of Schneiderian mucosal origin [1,2]. Three subtypes of this tumor are recognized: exophytic papilloma, oncocytic papilloma, and inverted papilloma [1,[3][4][5]. The inverted papilloma representing around 4% of all primary sinonasal tumors is the most common type of Schneiderian papilloma and it occurs predominantly in white males with mean age of 50 years [2,3,6]. ...
Inverted Schneiderian papilloma is an uncommon benign tumor that presents tendency to recur and propensity to be associated with malignancy in approximately 10% of the cases. Some of these lesions are isolated in the maxillary sinus, and predominantly affect white males with mean age of 50 years. We report a case of squamous cell carcinoma arising from inverted Schneiderian papilloma in the maxillary sinus extending to the mouth. The patient was submitted to extraction of a maxillary molar tooth four months before the exacerbation of the symptoms of nasal airway obstruction and facial enlargement. Computed tomography scan revealed a sinonasal mass causing opacification of the right maxillary sinus with destruction of the lateral nasal wall and maxillary sinus floor. The patient was referred to an oncology center for treatment and died from tumor progression one year after the cancer was diagnosed. The intention of this report is to alert dentists to include the inverted Schneiderian papilloma, either associated with squamous cell carcinoma, or not, in the differential diagnosis of maxillary sinus tumors with aggressive behavior, which may extend to the oral cavity or involve roots of teeth.
Amaç: Nazal kavite ve paranazal sinüslerin başlıca lezyonlarını inflamatuvar özellikteki benign lezyonlar oluştururken, malign lezyonlar oldukça nadirdir. Bu çalışmada, literatür bilgileri eşliğinde, nazal kavite ve paranazal sinüslerde kitle oluşturan lezyonların sıklığının ve dağılımlarının gözden geçirilmesi amaçlanmıştır. Gereç ve Yöntem: Kütahya Sağlık Bilimleri Üniversitesi Evliya Çelebi Eğitim Araştırma Hastanesi Patoloji birimimizde 2013-2018 yılları arasında raporlanan 447 olguya ait, nazal kavite ve paranazal sinüslerde görülen lezyonların histopatolojik tanıları ve yerleşimleri retrospektif olarak incelendi. Bulgular: Çalışmaya 295’i (%65,99) erkek, 152’si (%34,01) kadın olmak üzere 447 olgu dâhil edildi (E/K=1,94). Çalışmaya dâhil edilen olguların yaş ortalaması 43,54 olarak belirlendi. Histopatolojik olarak, 6 (%1,35) lezyon malign, 441 (%98,65) lezyon benign olarak saptandı. Nazal polip lezyonların büyük kısmını oluşturmaktaydı (% 82,78; 370 lezyon). Diğer benign lezyonlar: 30 (%6,72) sinonazal papillom (24 inverted papillom, 6 ekzofitik papillom), 16 (%3,58) piyojenik granülom, 11 (%2,46) mukosel, 3 (%0,68) fibrom, 2 (%0,45) nazoalveolar kist, 1 (%0,22) dev epidermoid kist, 1 (%0,22) glomanjioperisitom, 1 (%0,22) hemanjioendotelyoma, 1 (%0,22) anjioleiomyom, 1 (%0,22) respiratuvar epitelyal adenomatoid hamartom, 1 (%0,22) osteom, 1 (%0,22) fibröz displazi, 1 (%0,22) fibroepitelyal polip ve 1 (%0,22) hiperkeratotik aktinik keratoz olarak belirlendi. Malign lezyonlar ise 3 (%0,68) malign melanom, 2 (%0,45) skuamöz hücreli karsinom ve 1 (%0,22) adenoid kistik karsinom olarak saptandı. Sonuç: Sinonazal bölge lezyonları histopatojik inceleme ile benign ve malign olarak ayırt edilebilmektedir. Bu bölgedeki lezyonlar çoğunlukla benign nitelikte olup, lezyonların büyük kısmını nazal polipler oluşturmaktadır. Sinonazal bölgedeki maligniteler ise agresif tümörler olup, nadir olarak görülmektedir.
Human papillomaviruses (HPV) are the etiological factors of many benign and malignant lesions localized in the skin and mucous membranes in the region of the urogenital organs and head and neck. Currently, most assays for the detection of HPV are based on detecting the presence of viral nucleic acids, mostly viral DNA. These molecular techniques can be divided into: 1) methods based on a targeted, selective amplification of nucleic acids, 2) signal amplification methods, 3) nucleic acid hybridization assays. This paper presents and explains a number of different HPV detection methods and provides examples of some commonly available commercial tests.
Objectives/Hypothesis
To perform a systematic review and formal meta‐analysis of the literature reporting on HPV detection in sinonasal papillomas. Since first reported in 1983, the etiological role for human papillomavirus (HPV) in sinonasal papillomas has been subject to increasing interest.
Study Design
A systematic review, with meta‐analysis and formal meta‐regression.
Methods
Literature was searched through April 2012. The effect size was calculated as event rates (95% confidence interval [CI]), with homogeneity testing using Cochran's Q and I ² statistics. Meta‐regression was used to test the impact of study‐level covariates (HPV detection method, geographic origin, papilloma type) on effect size, and potential publication bias was estimated using funnel plot symmetry.
Results
Seventy‐six studies were eligible covering 1,956 sinonasal papillomas from different geographic regions. Altogether, 760 (38.8%) cases tested HPV‐positive; effect size 0.421 (95% CI 0.359‐0.485, random effects model). The summary HPV prevalence was highest (65.3%) in exophytic papillomas (EP), followed by inverted papillomas (37.8%) and cylindrical cell papillomas (22.5%). In meta‐analysis stratified by 1) HPV detection technique, 2) geographic study origin, and 3) papilloma type, the between‐study heterogeneity was significant only for the papilloma types ( P = .001). In meta‐regression, HPV detection method ( P = .102), geographic origin ( P = .149), or histological type ( P = .240) were not significant study‐level covariates. Some evidence for publication bias was found only for studies on EP. In sensitivity analysis, all meta‐analytic results were robust to all one‐by‐one study removals.
Conclusions
Variability in HPV detection rates in sinonasal papillomas is explained by their histological types (not by HPV detection method or geographic origin of study), but none of the three were significant study‐level covariates in formal meta‐regression. Laryngoscope, 2013
Since first suggested (in 1982), etiological role for human papillomavirus (HPV) in esophageal papillomas has aroused increasing interest. The objective of this study was to perform systematic review and formal meta-analysis of the literature reporting on HPV detection in esophageal squamous cell papillomas (ESCP). Literature was searched through May 2012. The effect size was calculated as event rates (95% CI), with homogeneity testing using Cochran's Q and I(2) statistics. Meta-regression was used to test the impact of study-level covariates (HPV detection method, geographic origin) on effect size, and potential publication bias was estimated using funnel plot symmetry. Thirty nine studies were eligible, covering 427 ESCPs from different geographic regions. Altogether, 132 (30.9%) cases tested HPV positive; effect size 0.375 (95% CI 0.319-0.434) using the fixed-effects (FE) model and 0.412 (95% CI 0.295-0.540) using the random-effects model. In meta-analysis stratified by (i) HPV detection technique and (ii) geographic study origin, the between-study heterogeneity was not significant (p = 0.071 and p = 0.105, respectively). In meta-regression, HPV detection method (p = 0.260) and geographic origin (p = 0.436) were not significant study-level covariates accounting for the heterogeneity in HPV prevalence. Some evidence for publication bias was found only for PCR-based studies, with a marginal impact on summary effect size estimates. In sensitivity analysis, all meta-analytic results were robust to all one-by-one study removals. In stratified meta-analysis and formal meta-regression, the variability in HPV detection rates in ESCPs is not explained by the HPV detection method or geographic origin of the study.
