Dear Sir,Iam Dr.Yin-Hung Chang from the Department of Otolaryngology,Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation.I would like to present a case of inverted papilloma with carcinoma change of lacrim...Dear Sir,Iam Dr.Yin-Hung Chang from the Department of Otolaryngology,Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation.I would like to present a case of inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity that had been successfully treated by endoscopic surgery.Lacrimal drainage apparatus tumors are rare but important展开更多
<strong>Background:</strong> Inverted Papilloma (IP) is the most common benign neoplasms arising from the mucosal lining of the of the Sino-Nasal tract with single or multifocal attachment sites. The high ...<strong>Background:</strong> Inverted Papilloma (IP) is the most common benign neoplasms arising from the mucosal lining of the of the Sino-Nasal tract with single or multifocal attachment sites. The high propensity to recur, local aggressive behavior and possibility of malignant transformation attract considerable interest. <strong>Objective:</strong> To assess the factors affecting Sino-nasal IP, malignant transformation rate, and post-operative recurrence rate. <strong>Methods:</strong> A retrospective study was carried out on all cases diagnosed as Sino-Nasal Papilloma between January 2010 and December 2020 at Salmaniya Medical Complex, Bahrain. Data gathered from medical records were analyzed using SPSS. A total of 49 Sino-Nasal Papilloma cases were recorded of which 37 were IP. Factors affecting Sino-Nasal IPs are presented. <strong>Results:</strong> Sino-Nasal IP was recorded in 37 cases, composed of 28 males and 9 females with first presentation average age of 45.86 years. These involved 20 cases in the left side, 14 in the right side and 3 were bilateral. Recurrence in males and females was found to be 35.7% and 33%, respectively, with an average of 12.6 months. The symptoms include nasal blockage (97.3%), epistaxis and postnasal drip (13.5% each), headache (8.1%) and hyposmia and rhinorrhea (5.4%, each). The main recurrence was at stage T2 (60.5%), while in smokers (26.7%) and non-smokers (50%). Malignant transformation occurred in one patient only (2.6%). <strong>Conclusion:</strong> IP is the most common type of SNP with male predominance. The recurrence rate is high with an average of a year and the malignant transformation occurred in 2.6 % of the cases.展开更多
Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This ...Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This study aimed to evaluate whether magnetic resonance imaging （MRI）,including dynamic contrast enhanced MRI （DCE-MRI）,could improve differentiation between IP and malignant tumors,and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.Methods Non-enhanced,static,and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results.MRI features of IP and malignant tumors including side,margin,T1 signal intensity,T1 homogeneity,T2 signal intensity,T2 homogeneity,lobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,pattern of enhancement,Tpeak,Tmax,Clmax,and TIC type were evaluated and correlated with histological findings.Results There were significant differences between IP and malignant tumors in T2 homogeneity,Iobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,Tpeak,Tmax and TIC types.A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity.Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity.Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern,extra-sinonasal involvement,and washout-type TIC for both observers （Wang XY and Zhang ZY）.Conclusion Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.展开更多
Objective:To clarify whether the serum squamous cell carcinoma antigen(SCCA)levels of patients with inverted papilloma(IP)are different from patients with nasal polyps(NP)and rhinitis.Materials and methods:Serum SCCA ...Objective:To clarify whether the serum squamous cell carcinoma antigen(SCCA)levels of patients with inverted papilloma(IP)are different from patients with nasal polyps(NP)and rhinitis.Materials and methods:Serum SCCA levels were measured in 30 patients with IP and 30 patients with NP at one day before surgery and seven days after surgery and measured in 28 patients with rhinitis.Results:Elevated serum SCCA levels(>1.5 ng/ml)were found in 80.0%of patients in the IP group,6.7%of patients in the NP group and 14.3%of patients in the rhinitis group,which was a significant difference.The medians of serum SCCA levels in the IP,NP and rhinitis groups were 3.9,0.8 and 1.1 ng/ml,respectively,which was a significant difference.The SCCA level in IP group was not significantly correlated according to Krouse Staging.There was a significant difference in serum SCCA levels between the pre-and postoperative stages in the IP group,at 3.9 and 0.8 ng/ml,respectively,while in the NP group the levels were 0.8 and 1.0 ng/ml,not significantly different.With regard to the IP diagnosis in the IP and NP group based on the SCCA level(>1.5 ng/ml),sensitivity and specificity was 80.0%and 93.3%,respectively.Conclusions:The serum SCCA level in patients with IP was elevated and then it decreased after surgery.This was different from NP and rhinitis patients who mostly had normal levels,which did not change.展开更多
基金Supported by Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation
文摘Dear Sir,Iam Dr.Yin-Hung Chang from the Department of Otolaryngology,Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation.I would like to present a case of inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity that had been successfully treated by endoscopic surgery.Lacrimal drainage apparatus tumors are rare but important
文摘<strong>Background:</strong> Inverted Papilloma (IP) is the most common benign neoplasms arising from the mucosal lining of the of the Sino-Nasal tract with single or multifocal attachment sites. The high propensity to recur, local aggressive behavior and possibility of malignant transformation attract considerable interest. <strong>Objective:</strong> To assess the factors affecting Sino-nasal IP, malignant transformation rate, and post-operative recurrence rate. <strong>Methods:</strong> A retrospective study was carried out on all cases diagnosed as Sino-Nasal Papilloma between January 2010 and December 2020 at Salmaniya Medical Complex, Bahrain. Data gathered from medical records were analyzed using SPSS. A total of 49 Sino-Nasal Papilloma cases were recorded of which 37 were IP. Factors affecting Sino-Nasal IPs are presented. <strong>Results:</strong> Sino-Nasal IP was recorded in 37 cases, composed of 28 males and 9 females with first presentation average age of 45.86 years. These involved 20 cases in the left side, 14 in the right side and 3 were bilateral. Recurrence in males and females was found to be 35.7% and 33%, respectively, with an average of 12.6 months. The symptoms include nasal blockage (97.3%), epistaxis and postnasal drip (13.5% each), headache (8.1%) and hyposmia and rhinorrhea (5.4%, each). The main recurrence was at stage T2 (60.5%), while in smokers (26.7%) and non-smokers (50%). Malignant transformation occurred in one patient only (2.6%). <strong>Conclusion:</strong> IP is the most common type of SNP with male predominance. The recurrence rate is high with an average of a year and the malignant transformation occurred in 2.6 % of the cases.
基金This work was supported by Beijing Excellent Talents Foundation （No. 2010D003034000033）, Beijing Municipal Natural Science Foundation （No. 7112030）, and High Levels of Health Technical Personnel in Beijing City （No. 2011-3-047）.
文摘Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This study aimed to evaluate whether magnetic resonance imaging （MRI）,including dynamic contrast enhanced MRI （DCE-MRI）,could improve differentiation between IP and malignant tumors,and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.Methods Non-enhanced,static,and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results.MRI features of IP and malignant tumors including side,margin,T1 signal intensity,T1 homogeneity,T2 signal intensity,T2 homogeneity,lobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,pattern of enhancement,Tpeak,Tmax,Clmax,and TIC type were evaluated and correlated with histological findings.Results There were significant differences between IP and malignant tumors in T2 homogeneity,Iobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,Tpeak,Tmax and TIC types.A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity.Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity.Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern,extra-sinonasal involvement,and washout-type TIC for both observers （Wang XY and Zhang ZY）.Conclusion Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.
文摘Objective:To clarify whether the serum squamous cell carcinoma antigen(SCCA)levels of patients with inverted papilloma(IP)are different from patients with nasal polyps(NP)and rhinitis.Materials and methods:Serum SCCA levels were measured in 30 patients with IP and 30 patients with NP at one day before surgery and seven days after surgery and measured in 28 patients with rhinitis.Results:Elevated serum SCCA levels(>1.5 ng/ml)were found in 80.0%of patients in the IP group,6.7%of patients in the NP group and 14.3%of patients in the rhinitis group,which was a significant difference.The medians of serum SCCA levels in the IP,NP and rhinitis groups were 3.9,0.8 and 1.1 ng/ml,respectively,which was a significant difference.The SCCA level in IP group was not significantly correlated according to Krouse Staging.There was a significant difference in serum SCCA levels between the pre-and postoperative stages in the IP group,at 3.9 and 0.8 ng/ml,respectively,while in the NP group the levels were 0.8 and 1.0 ng/ml,not significantly different.With regard to the IP diagnosis in the IP and NP group based on the SCCA level(>1.5 ng/ml),sensitivity and specificity was 80.0%and 93.3%,respectively.Conclusions:The serum SCCA level in patients with IP was elevated and then it decreased after surgery.This was different from NP and rhinitis patients who mostly had normal levels,which did not change.
