Sekine Motoki, Goto Fumiyuki, Saito Kosuke, Kaneda Shoji, Yamamoto Hikaru, Murakami Tomoaki, Okami Kenji
Department of Otolaryngology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2021 Apr 20;46(1):17-21.
Most maxillary sinus papillomas are confirmed when they have extended beyond the nasal cavity and are rarely found while localized in the maxillary sinus. We experienced two cases of localized papilloma in the maxillary sinus. Case 1 was a 69-year-old man with a localized left maxillary sinus lesion detected during a routine imaging examination. As the lesion was likely to be papilloma, we recommended that the patient undergo diagnostic surgery, which he refused. He experienced bloody rhinorrhea 1 year and 9 months after the first visit, and computed tomography (CT) showed increased lesions and bone destruction. Histological examinations revealed squamous cell carcinoma ex inverted papilloma. He died 5 years after the first visit. Case 2 was a 46-year-old woman in whom positron emission tomography/CT showed a localized right maxillary sinus lesion. Tissue biopsy results indicated oncocytic papilloma. Endoscopic resection was performed later. On an imaging examination, sinonasal papilloma was determined accidentally to be a localized lesion of the maxillary sinus. A detailed interpretation of the CT scan was useful in estimating sinonasal papilloma. Tissue biopsy or diagnostic surgery should be performed when sinonasal papilloma is suspected during appropriate image evaluation.
大多数上颌窦乳头状瘤在超出鼻腔范围时才能确诊，而局限于上颌窦内时则很少被发现。我们遇到了两例局限于上颌窦的乳头状瘤病例。病例1是一名69岁男性，在常规影像学检查中发现左侧上颌窦有局限性病变。由于该病变可能是乳头状瘤，我们建议患者接受诊断性手术，但他拒绝了。首次就诊1年9个月后，他出现了鼻出血，计算机断层扫描（CT）显示病变增大且有骨质破坏。组织学检查显示为倒置性乳头状瘤伴鳞状细胞癌。首次就诊5年后他去世了。病例2是一名46岁女性，正电子发射断层扫描/CT显示右侧上颌窦有局限性病变。组织活检结果显示为嗜酸性细胞乳头状瘤。后来进行了内镜下切除。在影像学检查中，鼻窦乳头状瘤意外地被确定为上颌窦的局限性病变。对CT扫描进行详细解读有助于评估鼻窦乳头状瘤。在适当的影像评估中怀疑鼻窦乳头状瘤时，应进行组织活检或诊断性手术。
