Late recurrence or secondary location? Towards a better understanding of the physiopathology of inverted papilloma

Eur Ann Otorhinolaryngol Head Neck Dis. 2013 Nov;130(5):289-91. doi: 10.1016/j.anorl.2012.11.004. Epub 2013 Jul 23.


Introduction: Inverted papilloma (IP) is the most frequent benign tumor of the nasal cavities. Recurrence is found in 12 to 14% of cases, mainly at the primary site, although also exceptionally in remote locations. The present paper discusses the physiopathogenesis of IP on the basis of a report of late second occurrence of IP at a remote location and a review of the literature.

Case report: A man, who had undergone surgery in 1997 for ethmoid IP at the age of 56, presented 11 years later with nasal cavity IP at a second (frontal) location, discovered serendipitously during systematic follow-up and managed surgically without complication.

Discussion and conclusion: The physiopathology of nasal cavity IP remains unexplained. No reliable histologic or biological markers predict risk of recurrence or of malignant transformation. The sole treatment is total surgical resection. The risk of local recurrence, often due to incomplete resection, is well known, but that of a secondary location is less so, and regular very long-term follow-up is justified.

Keywords: Endoscopic surgery; Inverted papilloma; Recurrence; Remote location; Sinus.

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Endoscopy
  • Ethmoid Sinus* / pathology
  • Ethmoid Sinus* / surgery
  • Follow-Up Studies
  • Frontal Sinus* / pathology
  • Frontal Sinus* / surgery
  • Humans
  • Image Enhancement
  • Incidental Findings
  • Magnetic Resonance Imaging
  • Male
  • Nasal Polyps / diagnosis*
  • Nasal Polyps / physiopathology*
  • Nasal Polyps / surgery
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / physiopathology*
  • Neoplasm Recurrence, Local / surgery
  • Neoplasms, Second Primary / diagnosis*
  • Neoplasms, Second Primary / physiopathology*
  • Neoplasms, Second Primary / surgery
  • Papilloma, Inverted / diagnosis*
  • Papilloma, Inverted / physiopathology*
  • Papilloma, Inverted / surgery
  • Paranasal Sinus Neoplasms / diagnosis*
  • Paranasal Sinus Neoplasms / physiopathology*
  • Paranasal Sinus Neoplasms / surgery
  • Reoperation
  • Risk Factors
  • Tomography, X-Ray Computed