title: Primary inverted papilloma of the middle ear with intracranial invasion.
abstract: BACKGROUND
  Primary inverted papillomas of the middle ear are extremely rare tumors, with only few cases published in the literature. They have a characteristic epithelium surface inversion to the inside of the stroma. Inverted papillomas are benign lesions but have a high propensity of recurrence, local aggressiveness, and association with malignancy.
  
  
  METHODS
  We present a patient with an inverted papilloma originating in the middle ear producing chronic otorrhea and facial nerve palsy treated with a subtotal petrosectomy.
  
  
  RESULTS
  During the follow-up, the patient developed an intracranial invasion of the tumor causing his death.
  
  
  CONCLUSIONS
  Primary inverted papillomas of the middle ear can have an extremely aggressive behavior despite their benign characteristics; therefore, an aggressive treatment must be performed in order to minimize the possibility of recurrence.
authors.affiliation: Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Coca-Pelaz
authors.affiliation: Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Justo
authors.initials: J
authors.lastname: Gómez-Martínez
authors.affiliation: Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Vivanco-Allende
authors.affiliation: Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Mario
authors.initials: M
authors.lastname: Hermsen
authors.affiliation: Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Llorente
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology*; D004428:Ear Neoplasms / Q000473:pathology* / Q000601:surgery; D004432:Ear, Middle / Q000473:pathology*; D005158:Facial Paralysis / Q000175:diagnosis; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D018308:Papilloma, Inverted / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Schneiderian papilloma; intracranial invasion; inverted papilloma; mastoid; middle ear