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[鼻腔鼻窦内翻性乳头状瘤的恶变:文献综述及临床病例]

[Malignization of sinonasal inverted papilloma: literature review and clinical case].

作者信息

Klimenko K E, Rusetsky Yu Yu, Zakharov V S

机构信息

Central State Medical Academy of the Presidential Administration of the Russian Federation, Moscow, Russia.

Central Clinical Hospital of the Presidential Administration of the Russian Federation, Moscow, Russia.

出版信息

Vestn Otorinolaringol. 2025;90(2):83-87. doi: 10.17116/otorino20259002183.

Abstract

Inverted papilloma (SIP) is a relatively rare benign epithelial tumor of the nasal cavity which characterized by an aggressive course with local destruction of surrounding structures, a tendency to recurrence and associated with malignancy. Etiology remains little understood. SIPs is most commonly associated with human papillomavirus (HPV) and mutations in the epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) genes, which are upregulated in recurrent SIPs.These factors are responsible for theinverted papilloma transformation into squamous cell carcinoma (SCC). Prognosis of sinonasal SCC is poor, in most cases likely owing to its advanced stage at presentation. Treatment includes complete SIP removal by endoscopic approach with histological examination. Follow-up of these patients is critical to diagnosing relapse, which can be either early or late. It is important to diagnose recurrence to enable early treatment, especially in case of associated carcinoma or malignancy. In case of SCC, additional radiotherapy and/or neoadjuvant chemotherapy is needed, because it shows promising results in improving outcomes. In this article, we present a clinical case of managing a patient with malignancy of inverted papilloma, which led to extensive destruction.

摘要

内翻性乳头状瘤(SIP)是鼻腔相对罕见的良性上皮性肿瘤,其特征为病程侵袭性,局部破坏周围结构,有复发倾向且与恶性肿瘤相关。病因仍知之甚少。SIP最常与人乳头瘤病毒(HPV)以及表皮生长因子受体(EGFR)和血管内皮生长因子(VEGF)基因的突变有关,这些基因在复发性SIP中上调。这些因素导致内翻性乳头状瘤转变为鳞状细胞癌(SCC)。鼻窦SCC的预后较差,在大多数情况下可能是由于其就诊时已处于晚期。治疗包括通过内镜手术完整切除SIP并进行组织学检查。对这些患者进行随访对于诊断复发至关重要,复发可能为早期或晚期。诊断复发以便早期治疗很重要,尤其是在伴有癌或恶性肿瘤的情况下。对于SCC,需要额外的放疗和/或新辅助化疗,因为其在改善预后方面显示出有前景的结果。在本文中,我们介绍了一例治疗内翻性乳头状瘤恶变患者的临床病例,该病例导致了广泛破坏。

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