inverted papilloma
{{Infobox medical condition (new)
| name = Inverted papilloma
| synonyms =Ringertz tumour
| image = Inverted papilloma high mag.jpg
| caption = Micrograph of an inverted papilloma of the urinary bladder. H&E stain.
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An inverted papilloma, also known as Ringertz tumour,{{Cite journal|url=https://pubmed.ncbi.nlm.nih.gov/4086856/|title=Inverted papilloma of the nose (Ringertz tumour)|first1=S. A.|last1=Hasan|first2=M.|last2=Aziz|first3=N. A.|last3=Faruqi|date=September 9, 1985|journal=Journal of the Indian Medical Association|volume=83|issue=9|pages=316–318|via=PubMed|pmid=4086856}} is a type of tumor in which surface epithelial cells grow downward into the underlying supportive tissue. It may occur in the nose and/or sinuses or in the urinary tract (bladder, renal pelvis, ureter, urethra). When it occurs in the nose or sinuses, it may cause symptoms similar to those caused by sinusitis, such as nasal congestion. When it occurs in the urinary tract, it may cause blood in the urine.
Diagnosis
Inverted papillomas are definitively diagnosed by histologic examination. However, magnetic resonance imaging (MRI) may show a characteristic feature described as a convoluted cerebriform pattern (CCP). A retrospective study published in the American Journal of Neuroradiology concluded that identification of CCP by MRI in a patient with a nasal tumor made the diagnosis of Inverted papilloma quite likely. The study reported the sensitivity and specificity to be 100% and 87% respectively. CCP can be associated with other malignant tumors as well.{{cite journal|vauthors = Jeon TY, Kim HJ, Chung SK, Dhong HJ, Kim HY, Yim YJ, Kim ST, Jeon P, Kim KH |title=Sinonasal Inverted Papilloma: Value of Convoluted Cerebriform Pattern on MR Imaging|journal=American Journal of Neuroradiology|date=May 22, 2008|volume=29|pages=1556–1560|pmid=18499786|doi=10.3174/ajnr.A1128|issue=8|pmc=8119066|doi-access=free}}
Treatment
The treatment of choice in sinus and nose is by Functional endoscopic sinus surgery.{{Cite journal |last1=Carta |first1=Filippo |last2=Verillaud |first2=Benjamin |last3=Herman |first3=Philippe |date=February 2011 |title=Role of endoscopic approach in the management of inverted papilloma |url=https://journals.lww.com/00020840-201102000-00006 |journal=Current Opinion in Otolaryngology & Head and Neck Surgery |language=en |volume=19 |issue=1 |pages=21–24 |doi=10.1097/MOO.0b013e3283425213 |pmid=21191294 |s2cid=25787142 |issn=1068-9508}}
Recurrence and malignification
Inverted papillomas of the sinus and nose have a high risk of recurrence after surgical treatment. The recurrence often occurs within 2 years after the surgery and at the initial anatomical site .{{Cite journal |last1=Woodworth |first1=Bradford A. |last2=Bhargave |first2=Geeta A. |last3=Palmer |first3=James N. |last4=Chiu |first4=Alexander G. |last5=Cohen |first5=Noam A. |last6=Lanza |first6=Donald C. |last7=Bolger |first7=William E. |last8=Kennedy |first8=David W. |date=September 2007 |title=Clinical Outcomes of Endoscopic and Endoscopic-Assisted Resection of Inverted Papillomas: A 15-Year Experience |url=http://journals.sagepub.com/doi/10.2500/ajr.2007.21.3086 |journal=American Journal of Rhinology |language=en |volume=21 |issue=5 |pages=591–600 |doi=10.2500/ajr.2007.21.3086 |pmid=17999796 |s2cid=23495202 |issn=1050-6586}} Inverted papillomas have a potential for malignant transformation in 5-15%.{{Cite journal |last1=Peng |first1=Phyllis |last2=Har-El |first2=Gady |date=July 2006 |title=Management of inverted papillomas of the nose and paranasal sinuses |url=https://linkinghub.elsevier.com/retrieve/pii/S0196070905002231 |journal=American Journal of Otolaryngology |language=en |volume=27 |issue=4 |pages=233–237 |doi=10.1016/j.amjoto.2005.11.005|pmid=16798398 }}
History
Inverted papillomae were first described by Nils Ringertz in 1938.{{Cite book|url=https://www.worldcat.org/oclc/257486867|title=Pathology of malignant tumors arising in the nasal and paranasal cavities and maxilla|first=Nils|last=Ringertz|date=January 9, 1938|publisher=Mercator|oclc=257486867}} He reported their microscopic appearance and their tendency to grow into the connective tissue stroma.{{citation needed|date=January 2021}}
Additional image
File:Bladder inverted papilloma histopathology (1).jpg|Histopathology representing an inverted papilloma of the urinary bladder that was cystoscopically resected. Hematoxylin and eosion stain.
File:Bladder inverted papilloma histopathology (2).jpg|Histopathology representing an inverted papilloma of the urinary bladder that was cystoscopically resected. Hematoxylin and eosion stain.
File:Bladder inverted papilloma histopathology (3).jpg|Histopathology representing an inverted papilloma of the urinary bladder that was cystoscopically resected. Hematoxylin and eosion stain.
File:Inverted Schneiderian Papilloma of the Nasal Cavity (8116183976).jpg|Inverted Schneiderian Papilloma of the Nasal Cavity.
File:Inverted Schneiderian Papilloma of the Nasal Cavity (8116184172).jpg|Inverted Schneiderian Papilloma of the Nasal Cavity with Abundant intraepithelial microabscesses.
References
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External links
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- [http://www.cancer.gov/dictionary?CdrID=346512 Inverted papilloma] entry in the public domain NCI Dictionary of Cancer Terms
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{{Epithelial neoplasms}}
{{Urologic neoplasia}}
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