Kuusisto Niina, Hagström Jaana, Kurdo Goran, Haapaniemi Aaro, Markkola Antti, Mäkitie Antti, Lilja Markus
Department of Oral Pathology and Radiology, University of Turku, FI-20520 Turku, Finland.
Department of Pathology, Helsinki University Hospital, FI-00029 Helsinki, Finland.
Diagnostics (Basel). 2025 Jun 27;15(13):1645. doi: 10.3390/diagnostics15131645.
Sinonasal inverted papilloma (SNIP) is a rare benign tumor that has potential for malignant transformation, usually into squamous cell carcinoma (SCC). The pre-operative differentiation between SNIP and SNIP-SCC is essential in determining the therapeutic strategy, but it is a challenge, as biopsies may fail to recognize the malignant part of the tumor. Further, a SNIP can also be locally aggressive and thus mimic a malignant tumor. This retrospective study compares the pre-operative differences in computed tomography (CT) and histologic findings between patients with a benign SNIP and those with a SNIP-SCC. Eight patients with SNIP-SCC were selected from the hospital registries of the Department of Otorhinolaryngology, Helsinki University Hospital (Helsinki, Finland). For each case a comparable SNIP case without malignancy was selected. Five histopathologic samples of both the SNIP and SNIP-SCC tumors were retrieved. CT images and the histopathologic samples were re-evaluated by two observers. The nasal cavity and ethmoid and maxillary sinuses were the most common sites for both tumor types. The SNIP tumors were mostly unilateral, and the SNIP-SCC tumors were both unilateral and bilateral. Only SNIP-SCC tumors demonstrated bone defects and orbital or intracranial invasion. Dysplastic findings such as dyskeratosis, nuclear atypia, and maturation disturbances were seen only in the SNIP-SCC tumors. Bony destruction and invasion of adjacent structures in pre-operative CT images seem to be pathognomonic signs of SNIP-SCC based on this series. To differentiate between SNIP and SNIP-SCC tumors all available pre-operative investigations are warranted.
鼻窦内翻性乳头状瘤（SNIP）是一种罕见的良性肿瘤，具有恶变潜能，通常恶变为鳞状细胞癌（SCC）。术前区分SNIP和SNIP-SCC对于确定治疗策略至关重要，但这是一项挑战，因为活检可能无法识别肿瘤的恶性部分。此外，SNIP也可能具有局部侵袭性，因此类似恶性肿瘤。本回顾性研究比较了良性SNIP患者和SNIP-SCC患者术前计算机断层扫描（CT）和组织学结果的差异。从芬兰赫尔辛基大学医院耳鼻喉科的医院登记处选取了8例SNIP-SCC患者。对于每例患者，选取1例无恶性病变的可比SNIP病例。获取了SNIP和SNIP-SCC肿瘤的5份组织病理学样本。两名观察者对CT图像和组织病理学样本进行了重新评估。鼻腔以及筛窦和上颌窦是两种肿瘤类型最常见的部位。SNIP肿瘤大多为单侧，而SNIP-SCC肿瘤有单侧和双侧。只有SNIP-SCC肿瘤表现出骨缺损以及眼眶或颅内侵犯。发育异常表现，如角化不良、核异型性和成熟障碍仅见于SNIP-SCC肿瘤。基于本系列研究，术前CT图像中的骨质破坏和对相邻结构的侵犯似乎是SNIP-SCC的特征性征象。为了区分SNIP和SNIP-SCC肿瘤，所有可用的术前检查都是必要的。
