Inverted Papilloma in a 61-year-old Man: A Case Report

Abstract

Introduction: Inverted papilloma is a benign epithelial tumor of cavum nasi and paranasal sinuses that originates on the mucosal surface of the sinonasal tract. The etiology of this tumor remains unknown although chronic sinusitis, allergy, and viral infections are suspected. Although it is a benign tumor, it has a tendency toward malignancy. We aim to present the report as a case of sinonasal inverted papilloma with clinical manifestations, and radiological and histopathological features in a 61-year-old male patient. Case Presentation: A 61-year-old man presented to the Department of Ear, Nose, and Throat (ENT), Bali Royal Hospital on 17 January 2023 with left nasal obstruction 5 years ago, and getting worse over 3 months. Due to the obstruction, he felt his sense of smell diminished. He also often sneezed had headaches and felt his left nose was bigger than his right. On examination, a grey-white mass with an irregular, slippery surface, and soft consistency were found. The mass did not bleed easily, was not painful when touched, and filled almost the entire cavum nasi sinistra. CT scan revealed rhinosinusitis of maxillary dextra et sinistra, ethmoidal dextra et sinistra, and frontalis sinistra with polyp shape and concha nasi sinistra protruding posteriorly. Functional Endoscopic Sinus Surgery (FESS) and extirpation under general anesthesia (GA) were planned. An excisional biopsy was sent for histopathological examination. Based on clinicohistopathologic, it suggests of final diagnosis of inverted papilloma. Conclusion: Due to the signs and symptoms of inverted papilloma are not specific, a CT scan and biopsy are needed to confirm the diagnosis. To reduce the recurrence of these tumors, complete tumor removal with an endoscopic approach is recommended. Long-term follow-up is also necessary to prevent the recurrence