The inverted Schneiderian papilloma: a 25-year study

Area of Science:

• Otolaryngology
• Pathology
• Oncology

Background:

• Inverted papillomas of the lateral nasal wall are controversial lesions with varied nomenclature.
• The designation "inverted Schneiderian papilloma" is proposed to accurately describe these tumors.
• Their etiology remains uncertain, but they are considered true epithelial neoplasms.

Purpose of the Study:

• To present clinical features and management of inverted Schneiderian papillomas.
• To highlight the recurrence, destructive capacity, and association with malignancy.
• To detail a surgical approach and its outcomes.

Main Methods:

• Retrospective review of 101 cases at Geisinger Medical Center over 25 years.
• Analysis of clinical presentation, tumor origin, and attributes.
• Evaluation of surgical management, recurrence rates, and associated malignancies.

Main Results:

• Nasal obstruction was the most frequent complaint.
• Tumors originated from the lateral nasal wall, middle meatus.
• Recurrence rate was 2% with a bold surgical approach; 8 patients had associated malignancy.

Conclusions:

• Inverted Schneiderian papillomas are aggressive neoplasms requiring complete surgical removal.
• A bold surgical approach via lateral rhinotomy or modified Weber-Ferguson incision is effective.
• Early diagnosis and aggressive management are crucial due to potential for recurrence and malignancy.