Malignant transformation of a large sinonasal squamous cell papilloma with bilateral nasopharyngeal, cervical lymph node metastasis

Sinonasal squamous papilloma is a benign epithelial tumor having variable squamous differentiation. It occurs in the nasal cavity and paranasal sinuses. Malignant transformation of sinonasal squamous papilloma is responsible for cancer-related deaths worldwide. We reported a 52-year old man diagnosed as malignant transformation of a large sinonasal squamous cell papilloma. Moreover, bilateral nasopharyngeal metastasis followed by parapharyngeal space and cervical lymph node metastasis are appeared. The pathology results of sinonasal and nasopharyngeal mass are both malignant transformation of inverted squamous cell papilloma. Considering the extension of the tumor and the fact that nasopharyngeal carcinoma is more sensitive to chemotherapy and radiation, we had strongly counseled the patient that operation should be evaluated after he received concurrent chemoradiation.