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Published on: February 28, 2019
Inverted Sinonasal Papilloma: Pheno-endotyping and Predictive Markers of Recurrence and Malignancy - A Systematic
María Paola Aguilera1, Daniela Pastene2, Joan Lop3
1Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic Barcelona, IDIBAPS, CIBERES, University of Barcelona, C. Villarroel 170, 08036, Barcelona, Catalonia, Spain. paola.aguilera1992@gmail.com.
Purpose Of Review:
This review aimed to summarize the inflammatory, microscopic, and histopathological features of inverted sinonasal papilloma (ISP) and to identify viral, molecular, and genetic predictors of recurrence and malignant transformation.
Recent Findings:
Recent studies describe a heterogeneous inflammatory microenvironment with mixed Th1/Th2/Th17 cytokine responses and epithelial neutrophilia as a defining hallmark. Considerable variability persists across studies evaluating viral and molecular markers. High-risk Human Papillomavirus type 18 (HR-HPV-18), Epidermal Growth Factor Receptor (EGFR) exon 20 mutations, p53 alterations, and p16 loss have been most consistently linked to recurrence and malignant progression. SNIP exhibits multifactorial biological behavior driven by inflammation, viral infection, and molecular dysregulation. These findings highlight the need for standardized histopathological and molecular criteria and prospective studies to refine recurrence prediction and early detection of malignant transformation.
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