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Orgain CA, Shibuya TY, Thompson LD, et al. Long-term follow-up of a patient with malignant transformation of inverted papilloma into sinonasal undifferentiated carcinoma. Allergy Rhinol (Providence). 2017;8(3):173-177doi: 10.2500/ar.2017.8.0209.
Orgain, C. A., Shibuya, T. Y., Thompson, L. D., Keschner, D. B., Garg, R., & Lee, J. T. (2017). Long-term follow-up of a patient with malignant transformation of inverted papilloma into sinonasal undifferentiated carcinoma. Allergy & rhinology (Providence, R.I.), 8(3), 173-177. https://doi.org/10.2500/ar.2017.8.0209
Orgain, Carolyn A, et al. "Long-term follow-up of a patient with malignant transformation of inverted papilloma into sinonasal undifferentiated carcinoma." Allergy & rhinology (Providence, R.I.) vol. 8,3 (2017): 173-177. doi: https://doi.org/10.2500/ar.2017.8.0209
Orgain CA, Shibuya TY, Thompson LD, Keschner DB, Garg R, Lee JT. Long-term follow-up of a patient with malignant transformation of inverted papilloma into sinonasal undifferentiated carcinoma. Allergy Rhinol (Providence). 2017 Oct 01;8(3):173-177. doi: 10.2500/ar.2017.8.0209. PMID: 29070275; PMCID: PMC5662543.
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Allergy Rhinol (Providence). 2017 Oct 01;8(3):173-177. doi: 10.2500/ar.2017.8.0209.

Long-term follow-up of a patient with malignant transformation of inverted papilloma into sinonasal undifferentiated carcinoma.

Allergy & rhinology (Providence, R.I.)

Carolyn A Orgain, Terry Y Shibuya, Lester D Thompson, David B Keschner, Rohit Garg, Jivianne T Lee

Affiliations

  1. Orange County Sinus Institute, Department of Otolaryngology, Southern California Permanente Medical Group, Irvine, California.
  2. Department of Pathology, Southern California Permanente Medical Group, Woodland Hills, California.

PMID: 29070275 PMCID: PMC5662543 DOI: 10.2500/ar.2017.8.0209

Abstract

INTRODUCTION: Inverted papillomas (IP) are benign sinonasal neoplasms, which account for 0.5-4% of all nasal tumors. IPs have been known to transform into squamous cell carcinoma in 5-15% of cases. Rarely, transformations to other malignancies have been reported. Here we report a unique case of malignant transformation of an IP into sinonasal undifferentiated carcinoma (SNUC).

METHODS: A case report with a literature review; institutional review board exempted. The clinical presentation, radiographic features, surgical intervention, histopathologic analysis, treatment, and outcome of the case were examined.

RESULTS: A 62-year-old man presented with a 3-month history of nasal airway obstruction, rhinorrhea, and postnasal drip refractory to medical therapy. He had a long history of exposure to fumes, chemicals, dusts, and solvents as a professional painter as well as a 45 pack-year history of smoking and alcohol abuse. The patient was ultimately found to have a left ethmoidal IP with a focus of malignant transformation into SNUC. Endoscopic resection was performed, followed by concurrent chemoradiation and adjuvant chemotherapy. After surgery, he had no evidence of recurrent disease after 9 years of follow-up.

CONCLUSIONS: IP is known to transform into squamous cell carcinoma. Here we report a rare case of malignant transformation into SNUC, a much more uncommon and aggressive lesion. Although traditionally associated with a poorer prognosis, the positive outcome for SNUC observed in this patient may potentially be attributed to early detection and timely therapeutic intervention.

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