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Int Arch Otorhinolaryngol 2014; 18(03): 332-335
DOI: 10.1055/s-0034-1370761
Case Report
Thieme Publicações Ltda Rio de Janeiro, Brazil

Sphenoid Sinus Inverted Papilloma: A Case Report and Literature Review

Gustavo Figueiredo Nunes Rabelo
1   ENT MR3, Otorhinolaryngology Department, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
,
Vinícius Antunes Freitas
2   ENT, Head and Neck Surgeon, Otorhinolaryngology Department, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
,
Bruno Hollanda Santos
3   Post graduation student, Otorhinolaryngology Department, IEP Santa Casa de Belo Horizonte
,
Diego Costa de Souza Ferreira
4   ENT MR2, Otorhinolaryngology Department, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
,
Ana Elisa Mota Silveira Magalhães
1   ENT MR3, Otorhinolaryngology Department, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
,
Mírian Cabral Moreira de Castro
5   PhD; Head of the Otorhinolaryngology Department, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
› Author Affiliations
Further Information

Publication History

09 June 2013

02 December 2013

Publication Date:
11 April 2014 (online)

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Abstract

Introduction Inverted papilloma is a rare benign tumor of the nasal fossa, which usually originates from its lateral wall. Only 5% of cases demonstrate exclusive sinus involvement. Primary sphenoid sinus involvement is even rarer. Although considered a benign lesion, the tumor has a potentially invasive nature and has also been found to have an associated malignancy rate of 7 to 15%.

Objectives To report a case of inverted nasal papilloma originating in a rare location: the sphenoid sinus.

Resumed Report a 56-year-old woman, presented to our outpatient clinic complaining of frontal headache, occasional otalgia and recent forgetfulness. She was initially evaluated by a neurologist and then submitted to a head magnetic resonance imaging. A lesion was found to be filling both sphenoid sinuses. Sinus computed tomography showed an opacified sphenoid sinus with apparent bony integrity. The patient underwent sphenoidotomy through a transnasal endoscopic approach. A bleeding papillomatous lesion was identified. A biopsy was performed and histopathologic study suggested inverted papilloma. The lesion was then completely resected. The patient has been followed for 60 days after surgery; no signs of recurrence were found upon flexible nasofibroscope examination.

Conclusion Inverted Papilloma exclusively involving the sphenoid sinus is a rare entity. Non specific symptomatology and Clinical presentation make this kind of tumor a diagnostic and therapeutic challenge. The Endoscopic Sphenoidotomy has been the treatment of choice. Close follow-up is required in order to detect possible recurrences and malignant transformation.

Keywords

inverted papilloma - nasal cavity - sphenoid sinus
 

  • References

  • 1 Phillips PP, Gustafson RO, Facer GW. The clinical behavior of inverting papilloma of the nose and paranasal sinuses: report of 112 cases and review of the literature. Laryngoscope 1990; 100 (5) 463-469
    Search in Google Scholar
  • 2 Vogel K. Zur pathologischen anatomie des harten papilloms der nase. Beitr Pathol Anat 1926; 23: 117-123
    Search in Google Scholar
  • 3 Edison BD. Primary inverting papilloma of the sphenoid sinus. Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol 1975; 80 (5) 434-437
    Search in Google Scholar
  • 4 McElveen Jr JT, Fee Jr WE. Inverting papilloma of the sphenoid sinus. Otolaryngol Head Neck Surg 1981; 89 (5) 710-712
    Search in Google Scholar
  • 5 Sethi DS. Isolated sphenoid lesions: diagnosis and management. Otolaryngol Head Neck Surg 1999; 120 (5) 730-736
    CrossrefSearch in Google Scholar
  • 6 Bielamowicz S, Calcaterra TC, Watson D. Inverting papilloma of the head and neck: the UCLA update. Otolaryngol Head Neck Surg 1993; 109 (1) 71-76
    CrossrefPubMedSearch in Google Scholar
  • 7 Woodruff WW, Vrabec DP. Inverted papilloma of the nasal vault and paranasal sinuses: spectrum of CT findings. AJR Am J Roentgenol 1994; 162 (2) 419-423
    CrossrefSearch in Google Scholar
  • 8 Clarke SR, Amedee RG. Schneiderian papilloma. J La State Med Soc 1997; 149 (9) 310-315
    Search in Google Scholar
  • 9 Yiotakis I, Psarommatis I, Manolopoulos L, Ferekidis E, Adamopoulos G. Isolated inverted papilloma of the sphenoid sinus. J Laryngol Otol 2001; 115 (3) 227-230
    Search in Google Scholar
  • 10 Azevedo CF, Lobato GL, Macoto KE. Evolution of endoscopic surgery in the treatment of inverted papilloma. Braz J Otorhinolaryngol 2013; 79 (1) 13-17
    CrossrefSearch in Google Scholar
  • 11 Durucu C, Baglam T, Karatas E, Mumbuc S, Kanlikama M. Surgical treatment of inverted papilloma. J Craniofac Surg 2009; 20 (6) 1985-1988
    CrossrefSearch in Google Scholar
  • 12 Sadeghi N, Ao-Dhahri S, Manoukian JJ. Transnasal endoscopic medilal maxillectomy for inverting papilloma. Laryngoscope 2003; 113 (4) 749-753
    CrossrefPubMedSearch in Google Scholar
  • 13 Kim WS, Hyun DW, Kim CH, Yoon JH. Treatment outcomes of sinonasal inverted papillomas according to surgical approaches. Acta Otolaryngol 2010; 130 (4) 493-497
    CrossrefSearch in Google Scholar
  • 14 Guillemaud JP, Witterick IJ. Inverted papilloma of the sphenoid sinus: clinical presentation, management, and systematic review of the literature. Laryngoscope 2009; 119 (12) 2466-2471
    CrossrefSearch in Google Scholar
  • 15 Lian F, Juan H. Different endoscopic strategies in the management of recurrent sinonasal inverted papilloma. J Craniofac Surg 2012; 23 (1) e44-e48
    CrossrefSearch in Google Scholar
  • 16 Krouse JH. Endoscopic treatment of inverted papilloma: safety and efficacy. Am J Otolaryngol 2001; 22 (2) 87-99
    CrossrefSearch in Google Scholar
  • 17 Cannady SB, Batra PS, Sautter NB, Roh HJ, Citardi MJ. New staging system for sinonasal inverted papilloma in the endoscopic era. Laryngoscope 2007; 117 (7) 1283-1287
    CrossrefPubMedSearch in Google Scholar
  • 18 Han JK, Smith TL, Loehrl T, Toohill RJ, Smith MM. An evolution in the management of sinonasal inverting papilloma. Laryngoscope 2001; 111 (8) 1395-1400
    CrossrefSearch in Google Scholar