Skull Base Rep 2011; 1(2): 111-114
DOI: 10.1055/s-0031-1280738
© Thieme Medical Publishers

Aggressive Inverted Papilloma with Intracranial Invasion and Short Malignization Time

Peter Valentin Tomazic1 , Heinz Stammberger1 , Walter Habermann1 , Christoph Schmid1 , Wolfgang Koele1 , Michael Mokry2 , Verena Gellner2 , Alfred Beham3
  • 1Department for General Otolaryngology, Head and Neck Surgery, Medical University Graz, Graz, Austria
  • 2Department of Neurosurgery, Medical University Graz, Graz, Austria
  • 3Institute of Pathology, Medical University Graz, Graz, Austria
Further Information

Publication History

Publication Date:
09 June 2011 (online)


Inverted papillomas (IP) are considered benign lesions with a prevalence up to 4% among all sinunasal tumors; however, invasive growth and varying tendency for malignization are reported in literature. We report the case of a 69-year-old woman suffering from a large, aggressively growing IP invading the orbit, skull base, and frontal lobe of the brain. Within only 3 months' time the papilloma showed transformation into an invasive carcinoma, leaving surgical therapy in vain due to explosive recurrence. Intracranial and intraorbital expansion by IP is possible despite histology not showing signs of malignancy initially. In “regular” IP close endoscopic follow-up is mandatory to not overlook recurrence harboring malignancy.


  • 1 Billroth T. Uber Den Bau Der Schleimhautpolypen. Berlin, Germany: G Reimer; 1855: 11-14
  • 2 Mirza S, Bradley P J, Acharya A, Stacey M, Jones N S. Sinonasal inverted papillomas: recurrence, and synchronous and metachronous malignancy.  J Laryngol Otol. 2007;  121 (9) 857-864
  • 3 Reh D D, Lane A P. The role of endoscopic sinus surgery in the management of sinonasal inverted papilloma.  Curr Opin Otolaryngol Head Neck Surg. 2009;  17 (1) 6-10
  • 4 Tomenzoli D, Castelnuovo P, Pagella F et al.. Different endoscopic surgical strategies in the management of inverted papilloma of the sinonasal tract: experience with 47 patients.  Laryngoscope. 2004;  114 (2) 193-200
  • 5 Constantino GdeT, Abdo T T, Romano F R, Voegels R L, Butugan O. The role of endoscopic surgery in the treatment of nasal inverted papilloma.  Braz J Otorhinolaryngol. 2007;  73 (1) 65-68
  • 6 Sautter N B, Citardi M J, Batra P S. Minimally invasive resection of frontal recess/sinus inverted papilloma.  Am J Otolaryngol. 2007;  28 (4) 221-224
  • 7 Holzmann D, Hegyi I, Rajan G P, Harder-Ruckstuhl M. Management of benign inverted sinonasal papilloma avoiding external approaches.  J Laryngol Otol. 2007;  121 (6) 548-554
  • 8 Jameson M J, Kountakis S E. Endoscopic management of extensive inverted papilloma.  Am J Rhinol. 2005;  19 (5) 446-451
  • 9 Schlosser R J, Mason J C, Gross C W. Aggressive endoscopic resection of inverted papilloma: an update.  Otolaryngol Head Neck Surg. 2001;  125 (1) 49-53
  • 10 Von Buchwald C, Larsen A S. Endoscopic surgery of inverted papillomas under image guidance—a prospective study of 42 consecutive cases at a Danish university clinic.  Otolaryngol Head Neck Surg. 2005;  132 (4) 602-607
  • 11 Lund V J. Optimum management of inverted papilloma.  J Laryngol Otol. 2000;  114 (3) 194-197
  • 12 Llorente J L, Deleyiannis F, Rodrigo J P et al.. Minimally invasive treatment of the nasal inverted papilloma.  Am J Rhinol. 2003;  17 (6) 335-341
  • 13 Kamel R H. Transnasal endoscopic medial maxillectomy in inverted papilloma.  Laryngoscope. 1995;  105 (8 Pt 1) 847-853
  • 14 Minovi A, Kollert M, Draf W, Bockmühl U. Inverted papilloma: feasibility of endonasal surgery and long-term results of 87 cases.  Rhinology. 2006;  44 (3) 205-210

Peter Valentin TomazicM.D. 

ENT-University Hospital Graz, Medical University Graz

Auenbruggerplatz 26/28, 8036 Graz, Austria