Inverted papilloma is a benign epithelial tumor with locally invasive nature commonly seen in the nasal cavity. It is named after its characteristic histological feature, that is, inversion of columnar or ciliated epithelium into the underlying stroma.1 It is an uncommon tumor comprising 0.5%–4% of primary tumors of the nasal cavity.1 It is significant due to its tendency to recur and due to synchronous as well as metachronous malignancies.2 It arises from the Schneiderian membrane of ectodermal origin, which is different from the endodermally derived mucosa of the respiratory tract.2
The etiology is not well established; however, human papillomavirus DNA has been implicated.3 The commonest site of origin is the lateral wall of the nasal cavity.2 The usual presentation is with unilateral nasal discharge (occasionally blood stained) with progressive nasal obstruction. The growths are usually pinkish and polypoidal in the lateral wall of the nasal cavity. Contrast-enhanced computed tomography revealed focal hyperostosis at the site of origin in the nasal cavity.2,3 A nasal mass with convoluted cerebriform pattern on the enhanced T1-weighted image on the magnetic resonance imaging scan usually suggests inverted papilloma.4 The diagnosis is confirmed on biopsy. The treatment of choice is wide excision, preventing recurrence. Radiation therapy is used in nonresectable tumors, residual tumors, and inverted papilloma associated with squamous cell carcinoma.5
Footnotes
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REFERENCES
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