Which is not a synonym of Inveed Papilloma
Correct Answer: Columnar cell papilloma
Description: Inveed papilloma (Transitional cell papilloma or Ringez tumour or Schneiderian papilloma). It is a tumour of the nonolfactory mucosa of nose (Schneiderian membrane) and paranasal sinuses. Most common site of origin is lateral wall of nose in the middle meatus; less commonly it arises from the maxillary, frontal or sphenoid sinus. It is so named because hyperplastic papillomatous tissue grows into the stroma rather than in exophytic manner. Human papilloma virus is thought to be responsible for its aetiology. Clinically, men are affected more than women in the age group of 40-70. It is almost always unilateral and presents with nasal obstruction, nasal discharge and epistaxis. It can invade sinuses or orbit. Orbital involvement causes proptosis, diplopia and lacrimation. On examination of nose or endoscopy, it presents as a pale polypoidal mass resembling a simple nasal polypus or polypi. Computed tomography (CT) and magnetic resonance imaging (MRI) show the location and extent of the lesion. MRI also helps to differentiate associated secretions in sinus from the actual tumour mass. Biopsy is essential for diagnosis. Care should be taken as simple nasal polypi may be associated with it or even the patient might have been operated for their removal. Treatment. Medial maxillectomy is the treatment of choice. It can be performed by lateral rhinotomy or sublabial degloving approach. These days endoscopic approach is preferred. In 10-15% of cases, it is associated with malignancy. Wider external surgical approaches may be required for tumour extending to the frontal sinus or orbit. Recurrence can occur. Radiotherapy is not advised as it may induce malignancy. Ref : Diseases of ENT by Dhingra 6th edition Pgno : 202
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