A 50-year-old furniture worker presents with a polypoid nasal mass, progressive nasal obstruction, and CT showing expansion of the left maxillary sinus with medial wall remodelling but no frank bone destruction. Histology shows an inverted papilloma. The most important concern regarding this lesion is:
- A High rate of spontaneous resolution
- B Strong association with HPV 6 and 11 with malignant transformation risk of 10–15% ✓
- C Bilateral occurrence in 80% of cases
- D Origin from the nasal floor with no recurrence after polypectomy
Correct answer: B. Strong association with HPV 6 and 11 with malignant transformation risk of 10–15%
Explanation
Sinonasal inverted (Schneiderian) papilloma has three clinically important features: it is almost always unilateral, it has a significant recurrence rate after simple polypectomy (due to its locally invasive growth pattern — inversion into underlying stroma), and it carries a 10–15% risk of synchronous or metachronous malignant transformation to squamous cell carcinoma. Endoscopic medial maxillectomy is the preferred surgical approach. Association with HPV types 6 and 11 is well documented.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.