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Year: 2014  Vol. 18   Num. 3  - Julyy/Sept
DOI: 10.1055/s-0034-1370761
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Case Report
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Sphenoid Sinus Inverted Papilloma: A Case Report and Literature Review
Author(s):
Gustavo Figueiredo Nunes Rabelo, Vincius Antunes Freitas, Bruno Hollanda Santos, Diego Costa de Souza Ferreira, Ana Elisa Mota Silveira Magalhes, Mrian Cabral Moreira de Castro
Key words:
inverted papilloma - nasal cavity - sphenoid sinus
Abstract:

Introduction: Inverted papilloma is a rare benign tumor of the nasal fossa, which usually originates from its lateral wall. Only 5% of cases demonstrate exclusive sinus involvement. Primary sphenoid sinus involvement is even rarer. Although considered a benign lesion, the tumor has a potentially invasive nature and has also been found to have an associated malignancy rate of 7 to 15%.

Objectives: To report a case of inverted nasal papilloma originating in a rare location: the sphenoid sinus.

Resumed Report: a 56-year-old woman, presented to our outpatient clinic complaining of frontal headache, occasional otalgia and recent forgetfulness. She was initially evaluated by a neurologist and then submitted to a head magnetic resonance imaging. A lesion was found to be filling both sphenoid sinuses. Sinus computed tomography showed an opacified sphenoid sinus with apparent bony integrity. The patient underwent sphenoidotomy through a transnasal endoscopic approach. A bleeding papillomatous lesion was identified. A biopsy was performed and histopathologic study suggested inverted papilloma. The lesion was then completely resected. The patient has been followed for 60 days after surgery; no signs of recurrence were found upon flexible nasofibroscope examination.

Conclusion: Inverted Papilloma exclusively involving the sphenoid sinus is a rare entity. Non specific symptomatology and Clinical presentation make this kind of tumor a diagnostic and therapeutic challenge. The Endoscopic Sphenoidotomy has been the treatment of choice. Close follow-up is required in order to detect possible recurrences and malignant transformation.

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