Inverted papilloma

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Inverted papilloma
Other namesRingertz tumour
Inverted papilloma high mag.jpg
Micrograph of an inverted papilloma of the urinary bladder. H&E stain.
Specialty Oncology   OOjs UI icon edit-ltr-progressive.svg

An inverted papilloma, also known as Ringertz tumour, [1] is a type of tumor in which surface epithelial cells grow downward into the underlying supportive tissue. It may occur in the nose and/or sinuses or in the urinary tract (bladder, renal pelvis, ureter, urethra). When it occurs in the nose or sinuses, it may cause symptoms similar to those caused by sinusitis, such as nasal congestion. When it occurs in the urinary tract, it may cause blood in the urine.

Contents

Diagnosis

Inverted papillomas are definitively diagnosed by histologic examination. However, magnetic resonance imaging (MRI) may show a characteristic feature described as a convoluted cerebriform pattern (CCP). A retrospective study published in the American Journal of Neuroradiology concluded that identification of CCP by MRI in a patient with a nasal tumor made the diagnosis of Inverted papilloma quite likely. The study reported the sensitivity and specificity to be 100% and 87% respectively. CCP can be associated with other malignant tumors as well. [2]

Treatment

The treatment of choice in sinus and nose is by Functional endoscopic sinus surgery. [3]

Recurrence and malignification

Inverted papillomas of the sinus and nose have a high risk of recurrence after surgical treatment. The recurrence often occurs within 2 years after the surgery and at the initial anatomical site . [4] Inverted papillomas have a potential for malignant transformation in 5-15%. [5]

History

Inverted papillomae were first described by Nils Ringertz in 1938. [6] He reported their microscopic appearance and their tendency to grow into the connective tissue stroma.[ citation needed ]

Additional image

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<span class="mw-page-title-main">Nasal cavity</span> Large, air-filled space above and behind the nose in the middle of the face

The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal cavity is the uppermost part of the respiratory system and provides the nasal passage for inhaled air from the nostrils to the nasopharynx and rest of the respiratory tract.

<span class="mw-page-title-main">Nasal concha</span> Piece of bone in the breathing passage of humans and other animals

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The sphenoid sinus is a paired paranasal sinus occurring within the body of the sphenoid bone. It represents one pair of the four paired paranasal sinuses. The pair of sphenoid sinuses are separated in the middle by a septum of sphenoid sinuses. Each sphenoid sinus communicates with the nasal cavity via the opening of sphenoidal sinus. The two sphenoid sinuses vary in size and shape, and are usually asymmetrical.

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Nasopharyngeal angiofibroma is an angiofibroma also known as juvenile nasal angiofibroma, fibromatous hamartoma, and angiofibromatous hamartoma of the nasal cavity. It is a histologically benign but locally aggressive vascular tumor of the nasopharynx that arises from the superior margin of the sphenopalatine foramen and grows in the back of the nasal cavity. It most commonly affects adolescent males . Though it is a benign tumor, it is locally invasive and can invade the nose, cheek, orbit, or brain. Patients with nasopharyngeal angiofibroma usually present with one-sided nasal obstruction with profuse epistaxis.

<span class="mw-page-title-main">Concha bullosa</span> Anatomical feature of the human nose

A concha bullosa is a pneumatized (air-filled) cavity within a nasal concha, also known as a turbinate. Bullosa refers to the air-filled cavity within the turbinate. It is a normal anatomic variant seen in up to half the population. Occasionally, a large concha bullosa may cause it to bulge sufficiently to obstruct the opening of an adjacent sinus, possibly leading to recurrent sinusitis and various head pains related to areas innervated by the trigeminal nerve. In such a case the turbinate can be reduced in size by endoscopic nasal surgery (turbinectomy). The presence of a concha bullosa is often associated with deviation of the nasal septum toward the opposite side of the nasal cavity.

<span class="mw-page-title-main">Squamous cell papilloma</span> Medical condition

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David William Kennedy is an American academician, surgeon, and otolaryngologist. He is currently serving as an emeritus professor at the University of Pennsylvania.

References

  1. Hasan, S. A.; Aziz, M.; Faruqi, N. A. (September 9, 1985). "Inverted papilloma of the nose (Ringertz tumour)". Journal of the Indian Medical Association. 83 (9): 316–318. PMID   4086856 via PubMed.
  2. Jeon TY, Kim HJ, Chung SK, Dhong HJ, Kim HY, Yim YJ, Kim ST, Jeon P, Kim KH (May 22, 2008). "Sinonasal Inverted Papilloma: Value of Convoluted Cerebriform Pattern on MR Imaging". American Journal of Neuroradiology. 29 (8): 1556–1560. doi: 10.3174/ajnr.A1128 . PMC   8119066 . PMID   18499786.
  3. Carta, Filippo; Verillaud, Benjamin; Herman, Philippe (February 2011). "Role of endoscopic approach in the management of inverted papilloma". Current Opinion in Otolaryngology & Head and Neck Surgery. 19 (1): 21–24. doi:10.1097/MOO.0b013e3283425213. ISSN   1068-9508. PMID   21191294. S2CID   25787142.
  4. Woodworth, Bradford A.; Bhargave, Geeta A.; Palmer, James N.; Chiu, Alexander G.; Cohen, Noam A.; Lanza, Donald C.; Bolger, William E.; Kennedy, David W. (September 2007). "Clinical Outcomes of Endoscopic and Endoscopic-Assisted Resection of Inverted Papillomas: A 15-Year Experience". American Journal of Rhinology. 21 (5): 591–600. doi:10.2500/ajr.2007.21.3086. ISSN   1050-6586. PMID   17999796. S2CID   23495202.
  5. Peng, Phyllis; Har-El, Gady (July 2006). "Management of inverted papillomas of the nose and paranasal sinuses". American Journal of Otolaryngology. 27 (4): 233–237. doi:10.1016/j.amjoto.2005.11.005. PMID   16798398.
  6. Ringertz, Nils (January 9, 1938). Pathology of malignant tumors arising in the nasal and paranasal cavities and maxilla. Mercator. OCLC   257486867.

PD-icon.svg This article incorporates public domain material from Dictionary of Cancer Terms. U.S. National Cancer Institute.