Multifocal inverted papillomas in the head and neck

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Pathology

Background:

• Inverted papilloma is a rare, benign neoplasm typically arising from the sinonasal tract.
• While usually confined to the nasal cavity, it can exhibit local aggressiveness and invade adjacent structures.
• Reported extranasal sites include the temporal bone, pharynx, nasopharynx, and lacrimal sac.

Observation:

• A 67-year-old male with a history of sinonasal inverted papilloma presented with a recurrent nasal mass and a large left neck mass.
• The patient had a history of inverted papillomas in multiple locations: sinonasal tract, temporal bone, and nasopharynx.
• The neck mass, initially concerning for malignancy, was pathologically confirmed as benign inverted papilloma, possibly originating from salivary gland tissue.

Findings:

• Pathological examination confirmed the neck mass was a benign inverted papilloma.
• No clear etiology or direct physical connection to the submandibular gland was identified for the neck lesion.
• The case highlights the potential for multicentricity and unusual presentations of inverted papilloma.

Implications:

• Aggressive primary resection is recommended to minimize local recurrence of inverted papilloma.
• Regular and adequate surveillance is essential for early detection of recurrences.
• Complete head and neck examinations are crucial for patients with sinonasal inverted papilloma due to the risk of multicentricity.