Inverted papillomas of the nasal and paranasal sinuses that involve the ocular/adnexal region.
OBJECTIVE
To review the management of inverted papillomas presenting to oculoplastic surgeons at three institutions and the outcomes of treatment.


METHODS
A retrospective review of medical notes of patients presenting with inverted papillomas that invaded the orbit during a 7-year period.


RESULTS
In total, six Caucasian patients were identified, the mean age at presentation was 63 years. The presenting features were nasal blockage, epiphora, proptosis and medial canthal mass. Four were classed as Stage IV and two as Stage III disease. The sites of origin were the lateral wall of the nose, frontal sinus, ethmoidal sinus and lacrimal system. The lesions were radiologically homogenous tumours with variable degrees of nose, paranasal sinuses and orbital involvement. Four out of six had foci of malignant transformation (two with carcinoma in situ and two with invasive squamous cell carcinoma). All were treated with surgical excision and three with adjunctive radiotherapy. One patient needed orbital exentration and subsequently died from complications of the tumour bleeding.


CONCLUSIONS
Inverted papillomas that invade the orbit are likely to be malignant and locally aggressive tumours. Early and wide surgical excision provides the best chance of removal and minimises recurrence. Radiotherapy may be a useful adjunct. Following surgical intervention, all cases require long term observation to ensure tumour control.
Ophthalmology Department, Conquest Hospital , Hastings , United Kingdom .
Manuel
M
Saldana
Michael
M
Wearne
Bijan
B
Beigi
Robert
R
Petrarca
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D009918:Orbital Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D018308:Papilloma, Inverted / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed