title: Late recurrence or secondary location? Towards a better understanding of the physiopathology of inverted papilloma.
abstract: BACKGROUND
  Inverted papilloma (IP) is the most frequent benign tumor of the nasal cavities. Recurrence is found in 12 to 14% of cases, mainly at the primary site, although also exceptionally in remote locations. The present paper discusses the physiopathogenesis of IP on the basis of a report of late second occurrence of IP at a remote location and a review of the literature.
  
  
  METHODS
  A man, who had undergone surgery in 1997 for ethmoid IP at the age of 56, presented 11 years later with nasal cavity IP at a second (frontal) location, discovered serendipitously during systematic follow-up and managed surgically without complication.
  
  
  CONCLUSIONS
  The physiopathology of nasal cavity IP remains unexplained. No reliable histologic or biological markers predict risk of recurrence or of malignant transformation. The sole treatment is total surgical resection. The risk of local recurrence, often due to incomplete resection, is well known, but that of a secondary location is less so, and regular very long-term follow-up is justified.
authors.affiliation: Service d'ORL et de chirurgie cervico-faciale, formation associée Claude-Bernard, CNRS UMR 8194, université Paris Descartes et Sorbonne Cité Paris, HEGP, 20, rue Leblanc, 75908 Paris cedex 15, France.
authors.forename: C
authors.initials: C
authors.lastname: Prud'homme
authors.forename: S
authors.initials: S
authors.lastname: Espinoza
authors.forename: C
authors.initials: C
authors.lastname: Badoual
authors.forename: O
authors.initials: O
authors.lastname: Laccourreye
authors.forename: P
authors.initials: P
authors.lastname: Bonfils
authors.forename: D
authors.initials: D
authors.lastname: Malinvaud
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000473:pathology / Q000601:surgery; D006801:Humans; D007089:Image Enhancement; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008297:Male; D009298:Nasal Polyps / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D018308:Papilloma, Inverted / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
keywords: Endoscopic surgery; Inverted papilloma; Recurrence; Remote location; Sinus