Incidental Histopathologic Finding of Sinonasal Inverted Papilloma Among Surgically Excised Polyps Increases the Risk of Tumor Recurrence

  • Franklin Mariño-SánchezEmail author
  • Gonzalo de los Santos
  • Ana Giribet
  • Alejandra Aguirre
  • Javier Alonso
  • Daniel L. Wansley
  • Ignacio Cobeta
Original Article


Inverted papilloma (IP) is a benign tumor remarkable for its tendency toward recurrence. Local relapse implicates incomplete resection concerning the bone adjacent to tumor base. The high false negative rates on biopsies, mainly when nasal polyps coexist, may affect the surgical management and outcomes. Our objective was to study the impact of preoperative histologic diagnosis in IP recurrence, particularly in patients with pre-surgical diagnosis of inflammatory polyps. A retrospective analysis of 62 patients treated for IP was conducted. Demographic data and information about smoking status, alcohol intake, tumor location, histology, presence of nasal polyps, staging, malignancy, previous biopsies and surgical approach were evaluated to identify factors associated with recurrence. Prevalence of nasal polyps was higher in patients with recurrence. Smoking history, alcohol abuse, staging, histologic type, malignancy and surgical approach were not associated with recurrence. The presence of nasal polyps at endoscopy was inversely associated with the diagnosis of IP at incisional biopsy. Incidental histologic diagnosis of IP after surgery increased the risk of recurrence more than tenfold. Biopsy reporting the diagnosis of IP previous to surgery was inversely associated to recurrence. In patients with IP, coexistence of nasal polyps at initial endoscopy and lack of pathological IP diagnosis prior to surgery are strongly associated with a higher risk of recurrence. When excisional biopsy reports IP incidentally, an early revision surgery should be considered in order to avoid future aggressive surgeries because of tumor recurrence.


Inverted papilloma Schneiderian papilloma Sinonasal tumor Incidental finding Risk factors 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  • Franklin Mariño-Sánchez
    • 1
    • 2
    Email author
  • Gonzalo de los Santos
    • 1
    • 3
  • Ana Giribet
    • 1
  • Alejandra Aguirre
    • 1
  • Javier Alonso
    • 1
  • Daniel L. Wansley
    • 4
  • Ignacio Cobeta
    • 1
    • 3
  1. 1.Unidad de Rinología, Servicio de OtorrinolaringologíaHospital Universitario Ramón y CajalMadridSpain
  2. 2.Research Group of Excellence 2014-SGR-748 (Generalitat de Catalunya), Immunoal lèrgia Respiratòria Clínica i Experimental (IRCE)Institut d’Investigacions Biomédiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
  3. 3.Universidad Alcalá de HenaresMadridSpain
  4. 4.Stem EuropeHospital Quirón PalmaplanasPalma de MallorcaSpain

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