An inverted papilloma (Schneiderian papilloma) of the nose characteristically arises from the lateral nasal wall. Its unique pathological behaviour includes all of the following EXCEPT:

• A High local recurrence rate (~20-30%) when incompletely excised
• B Association with HPV 6 and 11
• C Bilateral origin in the majority of cases, requiring bilateral endoscopic surgery ✓
• D Risk of synchronous or metachronous malignant transformation (~10-15%) to squamous cell carcinoma

Explanation

Inverted papilloma (IP) is characteristically UNILATERAL — bilateral IP is extremely rare and should raise suspicion of a second separate lesion rather than bilateral primary disease. Its characteristic features are: (1) lateral nasal wall origin (middle meatus, ethmoid, maxillary sinus); (2) locally aggressive with high recurrence (20-30%) if margins are not clear; (3) HPV 6 and 11 association; (4) ~10-15% risk of synchronous or metachronous transformation to SCC. Complete endoscopic resection with wide margins (medial maxillectomy if maxillary sinus involved) is the standard treatment. Serial surveillance endoscopy post-surgery is mandatory.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.