Inverted Papilloma

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Inverted Papilloma

Inverted papillomas are benign tumors caused by human papillomavirus (HPV) that usually arise on the lateral nasal wall. They present with unilateral nasal obstruction and occasionally hemorrhage. They are often easily seen on anterior rhinoscopy as cauliflower-like growths in or around the middle meatus.

Symptoms of inverted papillomas

Inverted papilloma symptoms may include:

  • Blocked nasal passages, usually just on one side
  • Runny nose/nasal discharge
  • Sinus infections
  • Nosebleeds

Diagnosis of inverted papillomas

Your doctor can diagnose an inverted papilloma by inserting a flexible tube called an endoscope into your nose. He or she will then take a sample of the tumor to confirm the diagnosis and determine whether it’s cancerous. You may also have a CT or MRI scan to determine the extent of the tumor.

Treatment options for inverted papillomas

Because squamous cell carcinoma is seen in about 10% of inverted or schneiderian papillomas, complete excision is strongly recommended. This usually requires a medial maxillectomy, but in selected cases an endoscopic approach may be possible. Because recurrence rates for inverted papilloma are reported to be as high as 20%, subsequent clinical and radiologic follow-up is imperative. All excised tissue (not just a portion) should be carefully reviewed by the pathologist to be sure no carcinoma is present.

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