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Inverted Papilloma Originating Primarily from the Nasolacrimal Duct: A Case Report and Review of the Pertinent Literature.

Walijee HZ, Berry S, Quine S, Lane C, Morris DS, Bowman B - Case Rep Otolaryngol (2015)

Bottom Line: Case.The patient made an uneventful recovery with unchanged visual acuity and normal extraocular movements.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant CF72 8XR, UK.

ABSTRACT
Introduction. Inverted papilloma (IP) is an uncommon, benign yet aggressive neoplasm characterised by high recurrence rates and tendency towards malignant transformation. The majority of IP cases originate in the ethmoid region, lateral wall of the nasal fossa, and maxillary sinus. The authors report a case of an IP originating primarily from the nasolacrimal duct (NLD). Case. A 69-year-old Caucasian gentleman presented with a lump in his right medial canthal region, epiphora, and discharge bilaterally. Radiological investigation revealed a well-defined, heterogeneous mass within the proximal NLD eroding the bony canal, protruding into the middle meatus and into the right orbit. The tumour was excised en bloc utilizing a combined external and endoscopic approach based on its location. Histology revealed hyperplastic ribbons of basement membrane-enclosed epithelium growing endophytically into the underlying stroma with no evidence of invasive malignancy. The patient made an uneventful recovery with unchanged visual acuity and normal extraocular movements. Conclusion. The case demonstrates variability within the sinonasal tract that IP can develop and the individuality of each case necessitating tailored operative techniques for complete excision whilst minimising recurrence rates. We also present a combined endoscopic approach for the en bloc resection of a NLD IP with no clinical recurrence at 15-month follow-up.

No MeSH data available.


Related in: MedlinePlus

Endoscopic view demonstrating a pale, polypoid-like mass, covered by a papillary surface, protruding from the middle meatus.
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fig3: Endoscopic view demonstrating a pale, polypoid-like mass, covered by a papillary surface, protruding from the middle meatus.

Mentions: Magnetic Resonance Imaging (MRI) of the head confirmed a mass arising from the proximal NLD, mildly hypointense on T2 weighted images, isointense on T1 weighted images, and avidly enhancing on postcontrast images eroding the anterior lamina papyracea and bulging into the medial aspect of the right orbit. Right nasal bones were eroded with the mass extending into the nasal cavity to lie in the middle meatus anteriorly (Figure 3).


Inverted Papilloma Originating Primarily from the Nasolacrimal Duct: A Case Report and Review of the Pertinent Literature.

Walijee HZ, Berry S, Quine S, Lane C, Morris DS, Bowman B - Case Rep Otolaryngol (2015)

Endoscopic view demonstrating a pale, polypoid-like mass, covered by a papillary surface, protruding from the middle meatus.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663298&req=5

fig3: Endoscopic view demonstrating a pale, polypoid-like mass, covered by a papillary surface, protruding from the middle meatus.
Mentions: Magnetic Resonance Imaging (MRI) of the head confirmed a mass arising from the proximal NLD, mildly hypointense on T2 weighted images, isointense on T1 weighted images, and avidly enhancing on postcontrast images eroding the anterior lamina papyracea and bulging into the medial aspect of the right orbit. Right nasal bones were eroded with the mass extending into the nasal cavity to lie in the middle meatus anteriorly (Figure 3).

Bottom Line: Case.The patient made an uneventful recovery with unchanged visual acuity and normal extraocular movements.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant CF72 8XR, UK.

ABSTRACT
Introduction. Inverted papilloma (IP) is an uncommon, benign yet aggressive neoplasm characterised by high recurrence rates and tendency towards malignant transformation. The majority of IP cases originate in the ethmoid region, lateral wall of the nasal fossa, and maxillary sinus. The authors report a case of an IP originating primarily from the nasolacrimal duct (NLD). Case. A 69-year-old Caucasian gentleman presented with a lump in his right medial canthal region, epiphora, and discharge bilaterally. Radiological investigation revealed a well-defined, heterogeneous mass within the proximal NLD eroding the bony canal, protruding into the middle meatus and into the right orbit. The tumour was excised en bloc utilizing a combined external and endoscopic approach based on its location. Histology revealed hyperplastic ribbons of basement membrane-enclosed epithelium growing endophytically into the underlying stroma with no evidence of invasive malignancy. The patient made an uneventful recovery with unchanged visual acuity and normal extraocular movements. Conclusion. The case demonstrates variability within the sinonasal tract that IP can develop and the individuality of each case necessitating tailored operative techniques for complete excision whilst minimising recurrence rates. We also present a combined endoscopic approach for the en bloc resection of a NLD IP with no clinical recurrence at 15-month follow-up.

No MeSH data available.


Related in: MedlinePlus