Inverted papilloma of the nasal cavity has a distinct clinical significance. Which of the following accurately describes its relationship to malignancy and the gold standard surgical approach?

• A It has no malignant potential; simple polypectomy is curative
• B Synchronous or metachronous squamous cell carcinoma occurs in 5–15% of cases; medial maxillectomy (endoscopic or open Caldwell-Luc) with complete resection is standard ✓
• C It always transforms to adenocarcinoma; radical maxillectomy with orbital exenteration is required
• D Malignant transformation occurs in 50% of cases; radiotherapy alone is preferred to avoid recurrence

Explanation

Inverted papilloma (Schneiderian papilloma, endophytic type) is a benign epithelial tumour arising from the lateral nasal wall (most commonly the middle turbinate and maxillary sinus). Approximately 5–15% of cases harbour synchronous or develop metachronous squamous cell carcinoma, making complete surgical excision mandatory. The gold standard is medial maxillectomy — historically via lateral rhinotomy (open), now largely performed endoscopically (endoscopic medial maxillectomy). High recurrence rate (15–25%) necessitates regular endoscopic surveillance. HPV (types 6, 11) has been implicated in pathogenesis.

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

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Written and medically reviewed by the StethoPrep medical team.