SINONASAL INVERTED PAPILLOMA WITH MALIGNANT CHANGE - A CASE REPORT

Abstract

Inverted papilloma is an uncommon benign, epithelial neoplasm originating from the schneiderian membrane of the nose and paranasal sinuses. It usually arises from the lateral wall of nose, in the middle meatus,often extending to the paranasal sinuses. It predominently affects males with mean age of 50 years. It is best known for its  invasiveness, tendency to recur and association with malignancy .Histologically Inverted papilloma is a tumor in which there is invasion of the neoplastic epithelium into the underlying stroma rather than proliferation outwards. The Pathogenesis remains unclear, although allergy, occupational pollutants, chronic sinusitis and viral infection (Human                Papilloma Virus) have been suggested as possible causes. It is associated with malignancy in approximately 10 percent of cases. We report a case of marked dysplasia arising from inverted papilloma. A 46 year old male presented with           recurrent Left nasal mass, Histopathologically proven to be inverted papilloma five months back. Previously managed by transnasal endoscopic surgery and now presented with a huge nasal mass involving both nasal cavity and left maxillary sinus and facial disfigurement . Biopsy from the mass proved to be sinonasal papilloma with malignant change exhibiting marked dysplasia with high mitotic index.