Introduction: Inverted papilloma (IP) is a benign sinonasal tumor with a tendency for locally aggressive
behavior and the potential for malignant transformation. Malignant transformation
occurs in less than 10% of IP cases and is most commonly associated with squamous
cell carcinoma. Mantle cell lymphoma arising in association with IP has not been previously
reported.
Methods: Case report of mantle cell lymphoma in association with IP and review of the literature.
Case Report: A 60-year-old male with history of chronic rhinosinusitis with nasal polyposis was
found to have synchronous lesions of inverted papilloma and mantle cell lymphoma.
The patient had a prior endoscopic polypectomy 13 years ago by his referring physician.
His symptoms of nasal obstruction and drainage had returned, with new complaints of
epistaxis and anosmia. Notably, he is morbidly obese and he has been self-medicating
with oxymetazoline sprays 4 times a day. He underwent an endoscopic sinus surgery
with findings of polyposis and suspicious lesions in the sphenoid sinus that were
sent separately. Final surgical pathology report revealed inverted papilloma without
dysplasia and mantle cell lymphoma. His postoperative PET-CT further identified disease
in the right lacrimal gland and right upper lip. He is currently undergoing rituximab
monotherapy.
Conclusion: IP is a benign tumor with known association with malignant transformation, usually
in the form of squamous cell carcinoma. This case report discusses a 60-year-old male
diagnosed with mantel cell lymphoma arising in association with IP, the first reported
in the English literature. Although exceedingly rare, synchronous or metachronous
lesions can occur with inverted papilloma and surgical specimens should always be
sent separately if clinical suspicion is high.
