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Schneiderian papilloma of the temporal bone
Lisa van der Putten1, Elisabeth Bloemena, Paul Merkus
1Department of Otorhinolaryngology, Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Abstract:
Temporal bone Schneiderian papilloma may present as a primary tumour originating from the middle ear and mastoid process, or an extension from sinonasal disease. Both forms are rare, this being only the 18th case of primary temporal bone Schneiderian papilloma described to date. Although the current patient has remained disease free after excision of the papilloma, the reported recurrence rate is high, comparable to sinonasal Schneiderian papilloma with extrasinus extension. Malignant progression of primary Schneiderian papillomas is significantly reduced as compared to Schneiderian papillomas that extend from the sinonasal tract into the temporal bone. A positive human papilloma virus status, as found in this case, is a common feature and prognostic factor of sinonasal Schneiderian papilloma but an infrequent finding in temporal bone disease. Owing to the high recurrence rate, the risk of malignant progression and the absence of reliable prognostic markers, stringent follow-up consisting of otoscopy, nasendoscopy and imaging is essential.
Insights
Primary temporal bone Schneiderian papilloma is rare and can recur frequently. Early detection and consistent follow-up are crucial for managing this middle ear tumor.
Area of Science:
- Otolaryngology
- Pathology
- Oncology
Background:
- Schneiderian papillomas (SPs) are rare tumors that can arise primarily in the temporal bone or extend from sinonasal disease.
- Primary temporal bone SPs are exceptionally rare, with only 18 cases documented, often originating in the middle ear and mastoid.
Observation:
- This case highlights a primary temporal bone SP, presenting a unique clinical scenario.
- The patient remained disease-free post-excision, but the high recurrence rate of temporal bone SPs mirrors that of sinonasal SPs with extrasinus extension.
Findings:
- Malignant progression is less common in primary temporal bone SPs compared to those extending from the sinonasal tract.
- Human papillomavirus (HPV) positivity, a known prognostic factor in sinonasal SPs, was observed in this case, though infrequent in temporal bone disease.
Implications:
- The high recurrence rate and potential for malignant transformation necessitate vigilant monitoring.
- Stringent follow-up protocols, including otoscopy, nasendoscopy, and imaging, are essential due to the lack of reliable prognostic markers.
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