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Sinonasal inverted papilloma with malignant transformation in the middle ear: a multicentric origin?
S Mazlina1, M A R Megat Shiraz, M Y S Hazim
1Department of Otorhinolaryngology - Head & Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. mazlinaselamat@yahoo.com
Abstract:
Inverted papilloma is a rare, benign tumour representing only 0.5 to 4 per cent of all sinonasal neoplasms; its involvement of the middle ear is extremely rare. We present a case of multicentric inverted papilloma in the sinonasal region and middle ear in a 54-year-old man. The patient later developed neck metastasis secondary to malignant transformation of the inverted papilloma in the middle ear.
Insights
A rare sinonasal tumor, inverted papilloma, exceptionally involved the middle ear in a 54-year-old man. This case highlights potential malignant transformation and neck metastasis, emphasizing the need for vigilance.
Area of Science:
- Otolaryngology
- Oncology
- Pathology
Background:
- Inverted papilloma (IP) is a rare sinonasal neoplasm (0.5-4% of all sinonasal tumors).
- Middle ear involvement by IP is exceptionally uncommon.
- Multicentric IPs present a diagnostic and therapeutic challenge.
Observation:
- A 54-year-old male presented with a sinonasal inverted papilloma.
- The tumor demonstrated multicentricity, involving both the sinonasal region and the middle ear.
- The patient developed subsequent neck metastasis.
Findings:
- The middle ear inverted papilloma underwent malignant transformation.
- Metastasis to the neck occurred secondary to the malignant transformation.
- This case underscores the potential for aggressive behavior in sinonasal inverted papillomas.
Implications:
- This case highlights the rare but significant risk of malignant transformation of sinonasal inverted papilloma, even with middle ear involvement.
- It emphasizes the importance of thorough evaluation and long-term surveillance for sinonasal inverted papillomas.
- Understanding the behavior of multicentric IPs is crucial for effective management and improved patient outcomes.
