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RECURRENCE AND MALIGNANT TRANSFORMATION RATES OF SINONASAL INVERTED PAPILLOMA: 63 CLINICAL CASES
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Abstract
Introduction: Sinonasal Inverted Papilloma (IP) is a benign pathology (accounting for 0.5-4% of all sinonasal tumors) but exhibits complex local invasion characteristics, a high postoperative recurrence rate (12-20%), and a potential for malignant transformation into Squamous Cell Carcinoma (SCC) (5-15%). Accurate identification of the attachment site and long-term management are key factors to improve prognosis. Objective: (1) To synthesize updated literature evidence from the last 10 years regarding recurrence mechanisms and risk factors for malignancy in IP; (2) To investigate epidemiological, clinical, and imaging characteristics, as well as treatment outcomes in 63 patients in Vietnam. Materials and Methods: A retrospective cross-sectional study was conducted on 63 patients diagnosed and surgically treated for IP from 2019 to 2025. Variables included: epidemiology, clinical symptoms, imaging characteristics (focal hyperostosis, cerebriform pattern), anatomical location, and follow-up results. Results: The mean age was 56.4; the male-to-female ratio was 1.4:1. Nasal obstruction was the predominant symptom (88.9%). The overall recurrence rate was 17.46% (11/63 cases), with the time to recurrence ranging from 6 months to 30 years. Early recurrence cases (<2 years) were primarily due to incomplete resection of the attachment site during the initial surgery. The malignant transformation rate was 1.58% (1/63 cases). Focal hyperostosis on CT scans was observed in 61.9% of patients and demonstrated high accuracy in locating the tumor attachment site. Conclusion: Sinonasal inverted papilloma in Vietnam shares similar epidemiological and clinical profiles with global literature. The 17.46% recurrence rate underscores the importance of attachment-oriented surgery and the role of drilling osteitic bone. Although malignant transformation is rare, it entails severe consequences, necessitating a strict postoperative surveillance protocol lasting at least 5-10 years.
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Keywords
sinonasal inverted papilloma, recurrence, malignant transformation, focal hyperostosis, cerebriform pattern.
References
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