Unique clinical and prognostic behavior of patients diagnosed with combined exophytic and inverted papilloma histologic subtype

Jakob L Fischer; Charles A Riley; Ashutosh Kacker

doi:10.1002/lio2.1191

Unique clinical and prognostic behavior of patients diagnosed with combined exophytic and inverted papilloma histologic subtype

Laryngoscope Investig Otolaryngol. 2023 Dec 19;9(1):e1191. doi: 10.1002/lio2.1191. eCollection 2024 Feb.

Authors

Jakob L Fischer^{1

2}, Charles A Riley^{1

2}, Ashutosh Kacker³

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery Walter Reed National Military Medical Center Bethesda Maryland USA.
² Department of Surgery Uniformed Services University of the Health Sciences Bethesda Maryland USA.
³ Department of Otorhinolaryngology Weill Cornell Medical College New York New York USA.

Abstract

Objectives: To evaluate the clinical and prognostic behaviors of sinonasal papillomas.

Methods: Patients diagnosed with sinonasal papilloma were reviewed between 2001 and 2016 at a tertiary rhinology practice. Using pathology-specific electronic medical record software, patients diagnosed with sinonasal papilloma were identified. Four subcategories of this lesion were identified: inverting (IP), exophytic (EP) oncocytic (OP) and inverting + exophytic (IP + EP) papillomas.

Results: A total of 107 patients were identified with unique sinonasal papilloma diagnoses. Of these, the majority were diagnosed with IP (87, 81.3%). The subpopulation of patients co-diagnosed with IP and EP (IP + EP) was unique with respect to clinical presentation and prognosis relative to both the IP and EP alone populations. IP + EP patients (5, 4.7%) were older with an average age of 75.25 years compared to 45 (EP) and 55.26 (IP), p < .0001. IP + EP patients more often presented with epistaxis (60%) compared to 33.3% (EP) and 4.6% (IP). Finally, all IP + EP patients had at least one recurrence of their disease, compared to 33.3% (EP) and 28.5% (IP).

Conclusions: Each histopathologic subtype of sinonasal papilloma has unique clinical characteristics and recurrence rates after surgical resection. The subpopulation of patients diagnosed with IP + EP tends to be older, more likely to present with epistaxis, and more likely to recur. Additional investigation and analysis of this subpopulation is warranted.

Level of evidence: 4.

Keywords: Schneiderian papilloma; exophytic papilloma; inverting papilloma; oncocytic papillomas; sinonasal mass; sinonasal neoplasm; sinonasal papilloma.

© 2023 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.