Flach Susanne, Ferguson Aaron Sj, White Sharon, White Paul S, Manickavasagam Jaiganesh
Department of Otolaryngology and Head & Neck Surgery, Ninewells Hospital, Dundee, UK.
Department of Otorhinolaryngology and Head & Neck Surgery, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
SAGE Open Med Case Rep. 2020 May 13;8:2050313X20922032. doi: 10.1177/2050313X20922032. eCollection 2020.
Inverted papilloma is a rare and benign tumour. It affects the nasal cavity and paranasal sinuses, has a high rate of recurrence and is associated with malignant transformation. Only few cases of a poorly differentiated carcinoma arising from inverted papilloma have been reported, none of which in the nasopharynx. We report a case of a 37-year-old female, who presented originally in 2012 with inverted papilloma of the nasal septum which was surgically resected. Nasopharyngeal biopsy from 2014 was reported as carcinoma in situ and treated with local endoscopic resection. Three years later she presented with a solitary lesion of the right Eustachian tube opening, confirmed as invasive poorly differentiated carcinoma. Imaging revealed T4 N2b M0 malignancy with skull base and prevertebral space invasion, likely extension into right temporal lobe and malignant adenopathy. Although rare, malignant transformation of inverted papilloma in unusual places should be considered during workup and monitoring of patients.
内翻性乳头状瘤是一种罕见的良性肿瘤。它累及鼻腔和鼻窦，复发率高且与恶变有关。仅有少数关于内翻性乳头状瘤恶变形成低分化癌的病例报道，其中无一例发生于鼻咽部。我们报告一例37岁女性患者，其最初于2012年被诊断为鼻中隔内翻性乳头状瘤并接受了手术切除。2014年的鼻咽活检报告为原位癌，并接受了局部内镜切除治疗。三年后，她出现右侧咽鼓管开口处的孤立性病变，确诊为浸润性低分化癌。影像学检查显示为T4 N2b M0期恶性肿瘤，侵犯颅底和椎前间隙，可能已延伸至右侧颞叶并伴有恶性淋巴结病。尽管罕见，但在对患者进行检查和监测时，应考虑内翻性乳头状瘤在不寻常部位的恶变情况。
