Sphenoid Sinus Inverted Papilloma: A Case Report and Literature Review
AUTOR(ES)
Rabelo, Gustavo Figueiredo Nunes, Freitas, Vinícius Antunes, Santos, Bruno Hollanda, Ferreira, Diego Costa de Souza, Magalhães, Ana Elisa Mota Silveira, Castro, Mírian Cabral Moreira de
FONTE
Int. Arch. Otorhinolaryngol.
DATA DE PUBLICAÇÃO
2014-09
RESUMO
Introduction Inverted papilloma is a rare benign tumor of the nasal fossa, which usually originates from its lateral wall. Only 5% of cases demonstrate exclusive sinus involvement. Primary sphenoid sinus involvement is even rarer. Although considered a benign lesion, the tumor has a potentially invasive nature and has also been found to have an associated malignancy rate of 7 to 15%. Objectives To report a case of inverted nasal papilloma originating in a rare location: the sphenoid sinus. Resumed Report a 56-year-old woman, presented to our outpatient clinic complaining of frontal headache, occasional otalgia and recent forgetfulness. She was initially evaluated by a neurologist and then submitted to a head magnetic resonance imaging. A lesion was found to be filling both sphenoid sinuses. Sinus computed tomography showed an opacified sphenoid sinus with apparent bony integrity. The patient underwent sphenoidotomy through a transnasal endoscopic approach. A bleeding papillomatous lesion was identified. A biopsy was performed and histopathologic study suggested inverted papilloma. The lesion was then completely resected. The patient has been followed for 60 days after surgery; no signs of recurrence were found upon flexible nasofibroscope examination. Conclusion Inverted Papilloma exclusively involving the sphenoid sinus is a rare entity. Non specific symptomatology and Clinical presentation make this kind of tumor a diagnostic and therapeutic challenge. The Endoscopic Sphenoidotomy has been the treatment of choice. Close follow-up is required in order to detect possible recurrences and malignant transformation.
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