obsolete inverted papilloma of paranasal sinus

Common Signs and Symptoms of Inverted Papilloma of Paranasal Sinus

Inverted papilloma, a benign but locally aggressive tumor, can cause various symptoms depending on its location in the paranasal sinuses. While it's worth noting that many cases may not exhibit any symptoms at all, patients who do experience signs and symptoms often report:

• Nasal congestion or obstruction: This is one of the most common symptoms, occurring in approximately 93.3% of cases (6).
• Nasal discharge or post-nasal drip: A significant number of patients (40%) experience nasal discharge or post-nasal drip (6).
• Epistaxis (nosebleeds): Epistaxis is reported by around 36.6% of patients (6) and can be a recurring issue.
• Decreased sense of smell: Some individuals may notice a reduction in their ability to smell, which can be distressing.
• Facial pain or swelling: Facial pain or swelling can occur due to the tumor's growth and pressure on surrounding structures.

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Diagnostic Tests for Inverted Papilloma

Inverted papilloma, a type of benign tumor, can be challenging to diagnose due to its non-specific symptoms and location in the paranasal sinuses. However, several diagnostic tests are available to confirm the presence of this condition.

• Fiberoscopy: This is considered the most valuable method for detecting tumour recurrence in patients with inverted papillomas [1].
• Rigid nasal endoscopy: Rigid nasal endoscopy with biopsy is the investigation of choice for inverted papilloma, allowing direct visualization and sampling of the lesion [3].
• Computed Tomography (CT) or Magnetic Resonance Imaging (MRI): These imaging modalities can be used to assess the extent of the disease and rule out any complications [4].

Other Diagnostic Methods

While not specifically mentioned in the context as a diagnostic test for inverted papilloma, endoscopic nasendoscopy has been advanced as a safe, inexpensive, and rapid means of directly visualizing lesions in the nasal cavity [2]. However, its role in diagnosing inverted papilloma is less clear.

References

[1] J Nowosielska-Grygiel (2017) - The most valuable method for detecting tumour recurrence in patients with inverted papillomas is fiberoscopy. [3] Nov 30, 2019 - Rigid nasal endoscopy: Rigid nasal endoscopy with biopsy is the investigation of choice for inverted papilloma. [4] by S Anari (2010) - Diagnosis is confirmed by histology but may require CT or MRI to assess accurately the extent of the disease.

The differential diagnosis for an obsolete inverted papilloma of the paranasal sinus involves considering other conditions that may mimic its presentation. According to various studies, the following conditions should be ruled out:

• Sinonasal carcinoma: This type of cancer can present similarly to an inverted papilloma and requires a thorough histological examination to confirm the diagnosis [2].
• Nonkeratinizing respiratory carcinoma and verrucous carcinoma: These types of carcinomas can also be considered in the differential diagnosis, particularly if there are concerns about malignant transformation [13].
• Sinonasal inflammatory polyps: While these are typically benign, they can cause similar symptoms to an inverted papilloma and may require imaging studies to confirm their presence.
• Other sinonasal tumors: Such as Schneiderian carcinoma or other rare tumors that may present with similar clinical features.

It's essential to note that a definitive diagnosis of an obsolete inverted papilloma requires histological examination, which can be challenging in cases where the tumor has regressed or is no longer present [3].

In addition, imaging studies such as CT or MRI scans can help assess the extent of any residual disease and guide further management decisions.

References:

[2] Nov 30, 2019 — Differential diagnosis​​ Other sinonasal diseases that may mimic inverted papilloma in the clinical presentation are sinonasal carcinoma, ...

[3] by S Anari · 2010 · Cited by 164 — Diagnosis is confirmed by histology but may require CT or MRI to assess accurately the extent of the disease.

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