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Inverted Papilloma in a 61-year-old Man: A Case Report


Introduction: Inverted papilloma is a benign epithelial tumor of cavum nasi and paranasal sinuses that originates on the mucosal surface of the sinonasal tract. The etiology of this tumor remains unknown although chronic sinusitis, allergy, and viral infections are suspected. Although it is a benign tumor, it has a tendency toward malignancy. We aim to present the report as a case of sinonasal inverted papilloma with clinical manifestations, and radiological and histopathological features in a 61-year-old male patient.

Case Presentation: A 61-year-old man presented to the Department of Ear, Nose, and Throat (ENT), Bali Royal Hospital on 17 January 2023 with left nasal obstruction 5 years ago, and getting worse over 3 months. Due to the obstruction, he felt his sense of smell diminished. He also often sneezed had headaches and felt his left nose was bigger than his right. On examination, a grey-white mass with an irregular, slippery surface, and soft consistency were found. The mass did not bleed easily, was not painful when touched, and filled almost the entire cavum nasi sinistra. CT scan revealed rhinosinusitis of maxillary dextra et sinistra, ethmoidal dextra et sinistra, and frontalis sinistra with polyp shape and concha nasi sinistra protruding posteriorly. Functional Endoscopic Sinus Surgery (FESS) and extirpation under general anesthesia (GA) were planned. An excisional biopsy was sent for histopathological examination. Based on clinicohistopathologic, it suggests of final diagnosis of inverted papilloma.

Conclusion:  Due to the signs and symptoms of inverted papilloma are not specific, a CT scan and biopsy are needed to confirm the diagnosis. To reduce the recurrence of these tumors, complete tumor removal with an endoscopic approach is recommended. Long-term follow-up is also necessary to prevent the recurrence



  1. Şahin, M. M., Yılmaz, M., Ekrem Zorlu, M., Göcek, M., Düzlü, M., Sayar, E., & Ceylan, A. (2021). Does evaluation of tumor volume or/both origination site better guide to optimal surgery for inverted papilloma?. Brazilian Journal of Otorhinolaryngology, 87, 396-401.
  2. Lund, V. J., Stammberger, H., Nicolai, P., Castelnuovo, P., Beal, T., Beham, A., ... & Wormald, P. J. (2010). European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl, 22(2), 1-143.
  3. Archang, M., Chew, L., Han, A. Y. K., Sajed, D., Vorasubin, N., & Wang, M. (2022). Sinonasal papillomas: 10-year retrospective analysis of etiology, epidemiology, and recurrence. American Journal of Rhinology & Allergy, 36(6), 827-834.
  4. Khandekar, S., Dive, A., Mishra, R., & Upadhyaya, N. (2015). Sinonasal inverted papilloma: A case report and mini review of histopathological features. Journal of oral and maxillofacial pathology: JOMFP, 19(3), 405.
  5. Riaz, Nabeela. (2020). Inverted Papilloma: A Case Report. JPDA, 29(01).
  6. Lisan Q, Laccourreye O, Bonfils P. (2016). Sinonasal inverted papilloma: From diagnosis to treatment. Europ Annals Otorhinolaryngol, head and Neck Dis. 133, 337-41.
  7. Osborne JE, Clayton M, Fenwick D. (2013). The leeds modified weber-fergusson incision. The Journal of Laryngology and Otology, 10(1):465-6
  8. Midyett, F. A., Mukherji, S. K., Midyett, F. A., & Mukherji, S. K. (2020). Inverted Papilloma. Skull Base Imaging: The Essentials, 87-90.
  9. Prasad, H., Sruthi, R., Anuthama, K., Perumal, M., & Parthasarathy, R. (2016). Inverted Sinonasal Papilloma Masquerading as a Malignancy-Report of an Unusual Case. Cureus, 8(3).
  10. Ali, M., Nabil, M., Safa, N., Hela, D., Sameh, M., Cyrine, Z., ... & Sonia, B. (2015). Diagnosis and management of benign tumors of nasal and paranasal cavities: 31 cases. The Egyptian Journal of Otolaryngology, 31(1), 4-9.
  11. Wassef, S. N., Batra P. S., and Barnett, S. (2012). Skull base inverted papilloma: a comprehensive review. ISRN Surgery, vol. 2012, Article ID 175903
  12. López, F., Shah, J. P., Beitler, J. J., Snyderman, C. H., Lund, V., Piazza, C., ... & Ferlito, A. (2022). The Selective Role of Open and Endoscopic Approaches for Sinonasal Malignant Tumours. Advances in therapy, 39(6), 2379-2397.
  13. Anari, S., & Carrie, S. (2010). Sinonasal inverted papilloma: narrative review. The Journal of Laryngology & Otology, 124(7), 705-715.
  14. Goudakos, J. K., Blioskas, S., Nikolaou, A., Vlachtsis, K., Karkos, P., & Markou, K. D. (2018). Endoscopic resection of sinonasal inverted papilloma: systematic review and meta-analysis. American Journal of Rhinology & Allergy, 32(3), 167-174.
  15. Patil, S.H.,& Rane, S.V. (2021). A Clinical Study of Complications of Functional Endoscopic Surgery (FESS) At A Tertiary Hospital. MedPulse International Journal of ENT, 20(2), 13-16
  16. Alekseenko, S., & Karpishchenko, S. (2020). Comparison of the efficiency and safety of endonasal and open rhinosurgery in children. The Laryngoscope, 130(4), 1056-1063.

How to Cite

Santosa, A. ., Permatasari, D. ., Laksmi, P. P. ., Devinta, M. R. S. ., & Saraswati, M. R. . (2023). Inverted Papilloma in a 61-year-old Man: A Case Report. Indonesia Journal of Biomedical Science, 17(1), 104–106.




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Agus Santosa
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Putu Pradnyasanti Laksmi
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Made Ratih Santi Devinta
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Made Ratna Saraswati
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