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Year: 2014  Vol. 18   Num. 3  - Julyy/Sept
DOI: 10.1055/s-0034-1370761
Case Report
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Sphenoid Sinus Inverted Papilloma: A Case Report and Literature Review
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

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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