Sinonasal inverted papilloma (Schneiderian papilloma) is associated with which clinically important characteristic that determines surgical approach?

• A High bilateral recurrence rate requiring bilateral ethmoidectomy
• B HPV 16/18 association requiring chemotherapy post-resection
• C Malignant transformation in 5-15% and local aggressiveness requiring complete en bloc excision ✓
• D Self-limited growth; conservative management appropriate

Explanation

Inverted papilloma (Schneiderian/transitional cell papilloma) has three important features: (1) locally aggressive behavior with bone erosion, (2) high recurrence rate if incompletely excised (20-78% with lateral rhinotomy, 0-10% with medial maxillectomy via FESS), and (3) synchronous or metachronous malignant transformation in 5-15% (typically to squamous cell carcinoma). HPV 6/11 (not 16/18) are associated. Complete en bloc resection — historically via medial maxillectomy, now often endoscopic — is the standard.

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.