Sinonasal papilloma

Sinonasal papilloma 

Updated: 10/12/2020

© Jun Wang, MD, PhD

General features
  • AKA Schneiderian papilloma
  • Benign
  • Usually adults, 2/3 men
  • Three subtypes
    • Inverted (Most common): Risk for malignant transformation
    • Fungiform (exophytic): No known risk for malignant transformation
    • Oncocytic: Risk for malignant transformation
Clinical presentations
  • Nasal obstruction, stuffiness or epistaxis
Key pathogenesis
  • Inverted: High and low risk HPV, EGFR mutation
  • Fungiform: Low risk HPV
  • Oncocytic: KRAS mutation
  • HPV associated tumorigenesis
Key morphological features
  • Soft to moderately firm, with granular or finely clefted surface
  • May have malignant foci
  • Inverted papilloma: Endophytic growth, non keratinizing squamous, transitional or respiratory epithelium
  • Fungiform papilloma: Exophytic growth, non keratinizing squamous, transitional or respiratory epithelium
  • Oncocytic papilloma: Oncocytic epithelium, intraepithelial mucin-filled cysts and microabscesses
Treatment
·         Surgery

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