ABSTRACT
Inverted papilloma (IP) is a rare, benign tumor of the nose and paranasal sinus. However, it is locally aggressive, the recurrence rate is high and malignant transformation is possible. Until now, IP of the hard palate has rarely been reported in the literature. Here, we reported a case with IP of the hard palate, which clinically presented as a carcinomatous growth. The management of IP is complete surgical excision with a close follow-up to detect early recurrence and/or malignant transformation
Subject(s)
Aged , Female , Humans , Palate, Hard , Papilloma, Inverted/complications , Papilloma, Inverted/diagnosis , Papilloma, Inverted/surgeryABSTRACT
El papiloma invertido (PI) es un tumor epitelial benigno, poco frecuente, que se origina mayormente de la pared nasal lateral. A pesar de ser benigno, constituye una lesión altamente invasiva de tejidos vecinos y puede sufrir una transformación maligna. El PI primario del seno esfenoidal con extensión intracraneana e invasión dural, aun sin evidencia histológica de malignidad, ha sido excepcionalmente descrito. Describimos el caso de una mujer de 59 años de edad que fue evaluada por cefaleas intensas de 5 años de evolución y anormalidades del campo visual. Una resonancia magnética nuclear (RMN) mostró una masa selar heterogénea de 1.4 por 2 cm con extensión supraselar y al seno esfenoidal, con erosión del piso selar y compresión del quiasma óptico. Recibió 16 mg/día de prednisona durante aproximadamente 3 meses con una regresión casi total de la masa en la RMN. En la evaluación hormonal se halló insuficiencia gonadal, tiroidea y adrenal central. En una nueva RMN se observó crecimiento del tumor con compromiso total del seno esfenoidal. Una biopsia endoscópica confirmó el diagnóstico de PI. Se realizó una cirugía sinusal transnasal endoscópica con una resección completa evidenciada en una RMN un año más tarde.
nverted papilloma (IP) is a benign uncommon epithelial tumor, arising mostly from the lateral nasal wall. Though benign, this lesion is highly invasive into surrounding tissues and malignant transformation may occur. Primary IP of the sphenoid sinus and intracranial extension with dural invasion, even without histological evidence of malignancy, has only rarely been described. Hypopituitarism as a complication of this lesion has never been reported. We describe the case of a 59-year-old woman who was evaluated because of a 5-year-history of severe headaches and abnormalities in the visual field. Magnetic resonance imaging (MRI) showed a 1.4 per 2.0 cm heterogeneous sellar lesion with suprasellar and sphenoid sinus extension, eroding the sellar floor with optic chiasm compression. Otolaryngologists gave her 16 mg/day of prednisone during approximately 3 months with a near total regression of the mass on MRI. The endocrine biochemical evaluation showed pituitary gonadal, thyroid and adrenal insufficiency. A new MRI showed growth of the tumor with obliteration of the sphenoid sinus. An endoscopic sinus biopsy revealed an IP, so a transnasal endoscopic sinus surgery was performed with complete resection evidenced by MRI a year later.
Subject(s)
Female , Humans , Middle Aged , Hypopituitarism/etiology , Papilloma, Inverted/complications , Paranasal Sinus Neoplasms/complications , Pituitary Neoplasms/etiology , Sphenoid Sinus , Biopsy , Diagnosis, Differential , Endoscopy , Hypopituitarism/diagnosis , Magnetic Resonance Imaging , Papilloma, Inverted/diagnosis , Paranasal Sinus Neoplasms/diagnosis , Pituitary Neoplasms/diagnosisABSTRACT
Papiloma invertido (PI) corresponde a 0,5 por cento-4 por cento dos tumores nasais benignos. A importância está na agressividade local, taxa de recorrência elevada e possibilidade de transformação maligna. O tratamento é controverso, encontrando melhor suporte na cirurgia endoscópica. OBJETIVO: Descrever aspectos clínico-epidemiológicos e tratamento dos casos de PI de um hospital terciário. CASUÍSTICA E MÉTODO: Estudo retrospectivo, realizado por revisão de prontuários de 26 pacientes com diagnóstico de PI nasal, avaliando localização tumoral, estadiamento clínico, tempo de seguimento, recidiva tumoral, malignidade, tipo de cirurgia realizada e complicações pós-operatórias. RESULTADO: Na casuística, havia 13 homens e 13 mulheres, com idade média de 57,8 anos. O tempo médio de seguimento foi de 29,4 meses, com 7,6 por cento de taxa de recidiva. Houve predomínio de tumores T3 e T4 e 3,8 por cento de taxa de malignidade. Todos foram submetidos a tratamento cirúrgico, predominando a cirurgia endoscópica endonasal. CONCLUSÃO: O PI é um tumor nasal originado principalmente na parede lateral nasal, mas também acomete seios paranasais. Avanços na cirurgia endoscópica vêm ganhando destaque pela menor invasividade e taxas de sucesso semelhantes às técnicas tradicionais externas, permitindo a exérese completa do tumor e proporcionando menor taxa de recidiva e tratamento completo no caso de malignidade.
Inverted papilloma (IP) comprises 0.5-4 percent of benign nasal tumors. The importance is shown by local aggressiveness, a high recurrence rate and the possibility of malignant transformation. The treatment is controversial, but endoscopic approaches tends to be the choice today. AIM: To describe clinical, epidemiological and treatment of IP cases in a tertiary hospital. METHODS: Retrospective study consisting of chart reviews of 26 patients diagnosed with IP; evaluation of tumor location, clinical staging, follow up, tumor recurrence, malignancy, type of surgery and postoperative complications. RESULTS: There were 13 men and 13 women, the mean age was 57.8 years. The mean follow up time was 29.4 months; the recurrence rate was 7.6 percent. There was a preponderance of T3 and T4 tumors and a 3.8 percent malignancy rate. All patients underwent surgical treatment, mostly endonasal endoscopic surgery. CONCLUSION: IP is an uncommon nasal tumor that originates mainly in the lateral nasal wall, but it also affects the paranasal sinuses. Advances in endoscopic surgery are gaining room due to lower invasiveness and success rates similar to traditional external techniques for completely resecting the tumor. There is a lower recurrence rate, and endoscopy a definitive treatment for malignancy cases in this study.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Nose Neoplasms/surgery , Papilloma, Inverted/surgery , Endoscopy , Follow-Up Studies , Neoplasm Recurrence, Local , Neoplasm Staging , Nose Neoplasms/diagnosis , Papilloma, Inverted/diagnosis , Retrospective Studies , Treatment OutcomeABSTRACT
O papiloma invertido schneideriano é uma neoplasia de origem no epitélio de revestimento que surge da mucosa respiratória revestindo a cavidade nasal e os seios paranasais. Frequentemente, surge como uma lesão unilateral no septo nasal e estende-se secundariamente para o nariz e os seios paranasais. Este trabalho relata um caso incomum desta patologia, com o envolvimento da cavidade oral em um homem branco, de 61 anos de idade, cuja avaliação clínica revelou uma massa vegetante no rebordo alveolar direito da maxila, com duração de aproximadamente 4 meses. Após avaliação radiográfica, constatouse o envolvimento do seio maxilar. A análise microscópica, hibridização in situ e análise imunoistoquímica da peça cirúrgica levaram a um diagnóstico de displasia moderada em PIS associado à infecção por HPV.
Inverted Schneiderian papilloma (ISP) is a neoplasm of epithelial lining origin which arises in the respiratory mucosa that lines the nasal cavity and paranasal sinuses. The inverted Schneiderian papilloma frequently appears as a unilateral lesion in the nasal septum and extends secondarily to the nasal and paranasal sinuses. This paper reports an unusual case of this pathology with involvement of the oral cavity in a 61-year-old white man. Clinical evaluation revealed a vegetating mass in the alveolar ridge of the right maxilla that had been present for approximately 4 months. After radiographic evaluation, involvement of the maxillary sinus was detected. Microscopic evaluation, in situ hybridization and immunohistochemical analysis of the specimen led to a diagnosis of ISP moderate dysplasia associated with HPV infection.
Subject(s)
Humans , Male , Middle Aged , Mouth Neoplasms/pathology , Papilloma, Inverted/pathology , Papillomavirus Infections/complications , Paranasal Sinus Neoplasms/pathology , Immunohistochemistry , In Situ Hybridization , Mouth Neoplasms/diagnosis , Mouth Neoplasms/virology , Neoplasm Invasiveness , Papilloma, Inverted/diagnosis , Papilloma, Inverted/virology , Papillomavirus Infections/diagnosis , Paranasal Sinus Neoplasms/diagnosis , Paranasal Sinus Neoplasms/virologyABSTRACT
El papiloma invertido es una tumoración de localización frecuente en la región naso sinusal, cuyas manifestaciones clínicas tardías y la posibilidad de recidiva y malignización obligan a un estudio exhaustivo y un tratamiento resolutivo. Objetivo: estudiar el comportamiento del papiloma invertido nasosinusal en los últimos nueve años. Método: se realizó un estudio descriptivo y longitudinal del papiloma invertido naso sinusal, en el Hospital Militar Universitario Dr. Octavio de la Concepción y de la Pedraja de Camagüey desde el año 2001 hasta el 2009. Se analizaron las variables, edad, sexo, raza, síntomas y signos, clasificación técnica quirúrgica y evolución post terapéutica. Se comentan y comparan los resultados. Resultados: en los seis pacientes estudiados con el diagnóstico de la enfermedad, el cuadro destructivo se acompañó de rinorrea, sin embargo en uno de ellos, la causa que motivó la solicitud de atención secundaria fue la expulsión de restos del tumor. En el 83.3 % de los casos el tumor por su extensión y localización se ubicó en los estadios II y IV de Krouse, previo estudio endoscópico e imagenológico para valorar su extensión y estadiamiento. Se realizó cirugía combinada o externa y con la experiencia acumulada se compararon los resultados con otros autores. Conclusiones: el papiloma invertido naso sinusal puede debutar con diferentes manifestaciones clínicas, siendo la más frecuente la obstrucción nasal. Se define la importancia de la remoción completa para lograr el éxito del tratamiento quirúrgico y una baja tasa de recidivas.
Inverted papilloma is a tumor of frequent location in the nasosinusal region, whose late clinical manifestations and the possibility of recidivation and malignancy requires an exhaustive study and a resolvent treatment. Objective: to study the behavior of nasosinusal inverted papilloma in the last nine years. Method: a descriptive and longitudinal study of nasosinusal inverted papilloma was conducted at the University Military Hospital Dr. Octavio de la Concepción y de la Pedraja of Camagüey, from 2001 to 2009. Variables like age, sex, race, symptoms and signs, surgical technical classification and evolution after therapeutics were analyzed. Results are commented and also compared. Results: in the six studied patients with the diagnosis of the disease, the destructive picture was accompanied by rhinorrhea; however in one of them, the cause that motivated the request of secondary attention was the expulsion of tumor´s remains. In the 83,3 % of cases, by its extension and location, the tumor was located in the stages II and IV of Krouse, previous endoscopic and imaging study to assessed its extension and staging. Combined or external surgery was accomplished, with the gained experience, results were compared with another authors. Conclusions: nasosinusal inverted papilloma may appear for the fist time with different clinical manifestations, being nasal obstruction the most frequent. It is define the importance of the complete removal to achieve the success of the surgical treatment and a low rate of recidivation.
Subject(s)
Humans , Nasal Obstruction , Paranasal Sinuses , Papilloma, Inverted/diagnosisABSTRACT
Se describe caso clínico de un paciente masculino de 28 años de edad con una lesión del tipo papiloma invertido estadio III según Krouse, la masa tumoral era dependiente de fosa nasal izquierda. El paciente acudió por primera vez a consulta por cuadro clínico de 7 meses de evolución consistente en obstrucción nasal, rinorrea purulenta, cefalea frontal y edema bipalpebral progresivo ipsilateral asociado a disminución de la agudeza visual. Previa realización de tomografía axial computarizada de senos paranasales y resonancia magnética cerebral contrastada se determinó la extensión tumoral y patrón de diseminación para seguidamente realizar un abordaje quirúrgico combinado (abierto más endoscópico)con reconstrucción con material de osteosíntesis del defecto óseo generado por la enfermedad. El procedimiento se realizó en el Hospital Universitario Clínica San Rafael de Bogotá D.C., Colombia en donde también se hizo seguimiento endoscópico y tomográfico mensual que al año confirmó que no habían signos de recidiva local ni secuelas derivadas del procedimiento quirúrgico, incluso se documentó que se restableció casi totalmente de la agudeza visual del lado afectado por descompresión de la órbita. Nuestro propósito es presentar un abordaje combinado, eficaz y seguro que pueda ser usado en la resección de papilomas invertidos de fosas nasales en estadios tardíos, presentar sus ventajas claras mayores tasas de curación, menores tasas de recidiva y malignización, y por lo tanto un pronóstico más favorable al ser comparado con resecciones endoscópicas parciales no complementadas con otro tipo de abordajes como el coronal.
Describes the clinical case of a 28- year- old male who has a lesion of the type of the inverted papilloma, stage III according to Krouse. The tumor like mass was a dependent of the left nostril. The patient came to the Doctors office for the first time due to a clinical chart that had evolved for 7 months. The evolution consisted of nasal obstruction, purulent rhinorrhea, a frontal cephalea and a progressive ipsilateral bipalpebral edema which was associated to a decrease in visual acuity. The extent of the tumor was determined by performing a CT Scan of the paranasal sinus and a contrasted MRI. This technique was also used to determine its dissemination pattern in order to perform a combined surgical approach (open plus endoscopic) with the reconstruction of the bone defect that had been generated by the disease, using osteosynthesis material. The procedure was performed at HospitalUniversitario Clínica San Rafael from Bogotá D.C, Colombia. An endoscopic and tomographic follow up was also performed on a monthly basis at the same hospital. After a years time it was confirmed that there were no signs of local relapses whatsoever nor were there side effects that derived from the surgical procedure. Visual acuity of the side that had been affected due to decompressing the orbit was re established almost in full. Our objective is to present a combined, effective and safe approach that may be used for the resection of inverted papillomas in the nostrils when they are in their late stages, present some clear advantages, greater healing rates, lower relapse rates as well as fewer possibilities for them to become malignant, and hence a more favorable prognosis as compared with partial endoscopic resections that are not complemented with other type of approaches such as the coronal approach.
Subject(s)
Papilloma, Inverted/classification , Papilloma, Inverted/diagnosis , Papilloma, Inverted/psychology , Papilloma, Inverted/rehabilitation , Papilloma, Inverted/therapyABSTRACT
Introdução: Descrição de caso clínico de rinosporidiose, doença granulomatosa crônica e rara, causada pelo Rhinosporidium seeberi. Objetivo: Incluir esta doença nos diagnósticos diferenciais de lesões polipoides das fossas nasais. Relato do Caso: Paciente do sexo masculino, proveniente do norte do Brasil, evoluiu por 3 anos, com lesão polipoide papilomatosa, da fossa nasal esquerda. Realizada sinusectomia com remoção de toda lesão, centrada em bula etmoidal e processo uncinado. Diagnóstico diferencial foi de papiloma invertido ou sinusite fúngica. O exame histopatológico revelou acentuada infestação por numerosas estruturas fúngicas com formas de esporângios repletas de esporangiósporos. Os microorganismos eram positivos para as colorações de Grocott, PAS e Mucicarmim; ao contrário do Coccidiodes immitis, que não se contrasta pelo mucicarmim. Não se optou por tratamento complementar e após 1 ano de seguimento não existem sinais de recidiva. Comentários Finais: A rinosporidiose deve ser considerada como diagnóstico diferencial das lesões polipoides nasais. No diagnóstico das lesões intranasais deve-se sempre considerar a procedência do paciente. É obrigatório o estudo anátomo-patológico para definir o diagnóstico. Na rinosporidiose, a exérese cirúrgica pode ser curativa.
Introduction: Clinical case report of rhinosporidiosis, a rare and chronic granulomatous disease, caused by Rhinosporidium seeberi. Objective: To include this disease in the differential diagnoses of polypoid lesions of the nasal mass. Report: A male patient from the North of Brazil evolved a three-year papilomatous polypoid lesion of the left nasal cavity. He was submitted to sinusectomy with resection of the entire lesion, located in ethmoid bulla and uncinated process. Inverted papilloma or fungal sinusitis were differential diagnoses. The histopathological examination revealed a strong infestation by numerous fungal structures with sporangia shape full of sporangiospores. The microorganisms were positive for colorations of Grocott, PAS and Mayer's Mucicarmin; opposite from Coccidioides immitis, which presents no contrast by the mucicarmin. We didn't choose complimentary treatment and after one year of follow-up he presents with no sign of recurrence. Final Comments: Rhinosporidiosis must be considered to be a nasal polypoid lesion differential diagnosis. In the intranasal lesions diagnosis we should keep in mind the patient's origin. The anatomopathological study is mandatory to set the diagnosis. In the rhinosporidiosis, the surgical exeresis can be a curative treatment.
Subject(s)
Humans , Male , Adult , Middle Aged , Papilloma, Inverted/diagnosis , Rhinosporidiosis/diagnosis , Sinusitis/diagnosis , Diagnosis, Differential , MycosesABSTRACT
O papiloma invertido é um raro tumor nasossinusal benigno e unilateral. As manifestações clínicas são inespecíficas, como obstrução nasal unilateral, rinorréia, epistaxe, hiposmia e cefaléia. O diagnóstico é realizado por meio de anamnese detalhada, exame otorrinolaringológico e exames complementares. A tomografia computadorizada e a ressonância magnética são exames fundamentais na elucidação diagnóstica, no tratamento e no acompanhamento do paciente. O tratamento é essencialmente cirúrgico. Este trabalho tem como objetivo relatar um caso de papiloma invertido bilateral e realizar uma revisão da literatura.
The inverted papilloma is an uncommon unilateral nasosinusal benign tumor. The clinical picture presents nonspecific signs and symptoms, such as unilateral nasal obstruction, anosmia and headache. The diagnosis is established by anamnesis, physical exam, computed tomography and magnetic resonance imaging. Treatment is essentially surgical. This report has the objective of presenting an uncommon bilateral inverted nasal papilloma and making a literature review.
Subject(s)
Humans , Male , Middle Aged , Nasal Cavity , Nose Neoplasms/diagnosis , Papilloma, Inverted/diagnosis , Nasal Obstruction , Nose Neoplasms/surgery , Papilloma, Inverted/surgery , Tomography, X-Ray ComputedABSTRACT
O papiloma invertido é um tumor benigno nasal que geralmente se origina na parede lateral da fossa nasal, mais especificamente da região do meato médio. Apresenta grande potencial invasivo local, com alta taxa de recorrência e potencial para transformação maligna. O acometimento do recesso esfenoetmoidal é raro e, quando ocorre, é decorrente de doença primária do seio esfenoidal. Não há relato de papiloma invertido isolado em recesso esfenoetmoidal na literatura. Relatamos um caso de papiloma invertido originado em recesso esfenoetmoidal, sem comprometimento do seio esfenoidal.
Inverted papilloma is a nasal benign tumor that usually arises from the lateral nasal wall, especially from the middle meatus. It has high local invasive likelihood, high recurrence rates and malignancy potential. Sphenoethmoidal recess involvement is rare and is usually due to sphenoid sinus primary disease. In the literature, no case of isolated sphenoethmoidal recess inverted papilloma has been reported yet. The present report describes an exceptional location of inverted papilloma, arising from the sphenoethmoid recess, without involving the sphenoid sinus.
Subject(s)
Adult , Humans , Male , Papilloma, Inverted/diagnosis , Paranasal Sinus Neoplasms/diagnosis , Sphenoid Sinus , Endoscopy , Papilloma, Inverted/pathology , Papilloma, Inverted/surgery , Paranasal Sinus Neoplasms/pathology , Paranasal Sinus Neoplasms/surgery , Sphenoid Sinus/pathology , Sphenoid Sinus/surgery , Tomography, X-Ray ComputedABSTRACT
Para definir as características dos papilomas invertidos schneiderianos e dos pólipos inflamatórios visíveis através da endoscopia nasal de contato, foram avaliados 11 pacientes com papiloma e nove pacientes com pólipo. A presença de aglomerados celulares, heterogeneidade celular, células vacuolizadas, epitélio respiratório e as características vasculares foram estatisticamente significantes para o diagnóstico diferencial entre estas duas entidades / In order to define the patterns of the inverted schneideran papillomas and nasal inflammatory polyps through contact endoscpy of the nose we evaluated 11 patients with papilloma and nine with polyp. The presence of clusters of cells, cellular heterogenecity, vacuolized cells, respiratory epithelium and vascular characteristics were statistically significant in differentiating the two entities...
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Endoscopy , Papilloma, Inverted/diagnosis , Nasal Polyps/diagnosis , Diagnosis, DifferentialABSTRACT
Paciente masculino de 54 años con un papiloma invertido (PI) que ocupa la fosa nasal derecha, pared medial del seno maxilar, etmoides, extendiéndose hasta la nasofaringe, respetando el seno frontal, esfenoidal y las paredes lateral y ántero-inferior del seno maxilar. Se práctico tratamiento quirúrgico efectuándosele una maxilectomía medial modificada más etmoidectomía total, ambas por vía endoscópica. Se revisa la técnica quirúrgica endoscópica y la literatura en cuanto a las indicaciones, contraindicaciones y limitaciones de este tipo de abordaje y, además, su comparación respecto a las vías clásicas externas.
Subject(s)
Humans , Male , Middle Aged , Nasal Cavity/surgery , Nasal Cavity/pathology , Surgery, Oral , Endoscopy , Papilloma, Inverted/surgery , Papilloma, Inverted/diagnosis , Ethmoid Sinus/surgery , Nasal Obstruction/surgeryABSTRACT
Midfacial degloving surgical approach is an excellent alternative to the lateral rhinotomy in exposure to the nasal cavity, paranasal sinuses and the nasopharynx. By lifting the soft tissue from the midportion of the face, many extensive benign tumors such as inverted papilloma, nasopharyngeal angiofibroma and some limited malignant lesions could be safely removed. This procedure could be combined with other approaches such as transtemporal, intracranial approach to resect more extensive tumors around the orbit, central skull base, as well. This technique was applied in 40 cases, ranging from 12-72 years of age and in a variety of diseases in Siriraj Hospital from 1991 to 2000. Fifty five per cent were diagnosed as inverted papilloma and 20 per cent were nasopharyngeal angiofibroma. The surgical technique in this operation was emphasized and it has proved to be an extensively valuable procedure for wide exposure of the operative field without any external scar. Functional outcome was obtained in most of the cases with minimal complications.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Nose Neoplasms/diagnosis , Otorhinolaryngologic Surgical Procedures/methods , Papilloma, Inverted/diagnosis , Paranasal Sinus Neoplasms/diagnosis , Postoperative Complications , Prognosis , Retrospective Studies , Risk Assessment , Sensitivity and Specificity , Thailand , Treatment OutcomeABSTRACT
Introducao: Os papilomas invertidos (PI), também denominados papiloma schneideriano, säo tumores benignos, nas insidiosos, que podem levar a danos irreversíveis se näo forem diagnosticados e tratados precocemente, principalmente devido à sua alta taxa de recidiva e associaçäo com carcinoma espino celular. Objetivos: O objetivo deste trabalho foi estudar, retrospectivamente, 14 pacientes portadores de PI submetidos a tratamento cirúrgico na Clínica Otorrinolaringológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo, no período de 1388 a 1998. Resultados: Do total de 14 pacientes estudados, 10 (71,4 por cento) eram do sexo masculino; e 4 (28,6 por cento), do sexo feminino. A idade variou de 27 a 65 anos (media = 47,6 anos; dp = 13,5 anos). A maioria (n = 8; 57,1 por cento) encontrava-se entre a 5ª e a 6ª décadas de vida. O principal sintoma foi obstruçäo nasal unilateral, apresentado por todos (n = 14), seguido por rinorréia purulenta (n = 10; 71,4 por cento) e epistaxe uni lateral e hiposmia (n = 9; 64,3 por cento). Todos os PI (n = 14; 100 por cento) possuíam origem na parede lateral da fossa nasal. Todos foram submetidos a cirurgia, sendo 7 (50 por cento) por via Caldwell-Luc, 5 (35,7 por cento) por via endoscópica endonasal, um (7,2 por cento) por Degloving, e outro (7,2 por cento), por via combinada Degloving e pára-lateronasal. Em apenas um paciente operado em nosso Serviço ocorreu recidiva, sendo que em nenhum caso foi observada transformaçäo maligna. Conclusäo: O diagnóstico precoce associado com intervençäo cirúrgica imediata säo essenciais no prognóstico dos portadores do PI. O uso do endoscópio durante o ato cirúrgico e, principalmente, no acompanhamento pós-operatório tem-se mostrado extremamente útil
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Papilloma, Inverted/diagnosis , Papilloma, Inverted/surgery , Endoscopy , Epistaxis , Nasal Obstruction , Paranasal Sinus Neoplasms , RecurrenceABSTRACT
O Papiloma Invertido da fossa nasal e seios paranasais requer um diagnóstico precoce e uma terapia cirúrgica agressiva. Muitos tratamentos cirúrgicos têm sido relatados na literatura, com uma grande variedade de resultados. Existem também aspectos duvidosos, como sua associaçäo ou transformaçao em carcinoma, e sua presumível etiologia viral. No presente trabalho, mostraremos nosso tratamento preferencial e relataremos um caso no qual sua evoluçäo clínica mostra a agressividade da lesäo, sua provável etiologia viral e sua transformaçäo em um carcinoma epidermóide. O estudo relata o caso de uma jovem com várias recorrências de papiloma invertido na fossa nasal esquerda e seios paranasais que se transformou em carcinoma epidermóide, com aparecimento concomitante na regiäo temporal direita.