Skull Base Inverted Papilloma: A Case Report

Inverted papilloma is an uncommon primary nasal. Despite its benign nature, this tumor represents three typical characteristics: a high propensity of recurrence, local aggressiveness and association with malignancy. Inverted papilloma can reduce the patient’s quality of life due to compromised nasal function, extension to orbit and brain even in absence of malignancy. We are presenting a case of 66 year old male patient with bilateral inverted papilloma with intracranial extensions after multiple recurrences operated 10 times over a period of 28 years, with extensive resection of disease every time but without any evidence of malignancy till date still showing fast and aggressive recurrences. Shalaka Sharma1*, Divij Sonkhya2 and Nishi Sonkhya3 1Department of Otolaryngology, SMS Medical College and Hospital, India 2Department of Otolaryngology, Sonkhya Hospital, India 3Department of Otolaryngology, SMS Medical College and Hospital, India Shalaka Sharma, et al., Annals of Clinical Case Reports Otolaryngology: Case Reports Remedy Publications LLC., | http://anncaserep.com/ 2016 | Volume 1 | Article 1219 2 nasal wall and a cystic mass seen hanging from roof of nasal cavity. Since recurrent Inverted Papilloma was suspected patient was elected for CT and MRI of head and neck areas which showed heterogeneous opacification of mass in right maxillary sinus, with minimal lesion in left maxillary sinus and nasal cavity. Nasal septal perforation due to prior endonasal resections was also observed (Figure 3).Cystic mass occupying frontoethmoid region with intracranial extension (Figure 1 and 2). Under general anesthesia patient underwent endoscopic excision of tumor from lateral nasal wall and maxillary sinus along with aspiration of fluid from the cyst. Histopathological study of the resected specimen as well as cytology of the fluid confirmed the diagnosis of Inverted Papilloma without evidence of malignancy. Further HPV studies of the patient came negative.