Clinical Implications of Carcinoma In Situ in Sinonasal Inverted Papilloma

2019 ◽  
Vol 161 (6) ◽  
pp. 1036-1042 ◽  
Author(s):  
Ivy W. Maina ◽  
Charles C. L. Tong ◽  
Esther Baranov ◽  
Neil N. Patel ◽  
Vasiliki Triantafillou ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Recurrence Rate ◽  
Carcinoma In Situ ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma ◽  
Definitive Surgery ◽  
Severe Degree ◽  
Multiple Recurrences

Objective Sinonasal inverted papilloma (IP) is a typically benign sinonasal tumor with a tendency to recur and the potential for malignant transformation. Varying degrees of dysplasia may be present, of which carcinoma in situ (CIS) is most advanced. We hereby describe the biological and clinical behavior of IP with CIS (IPwCIS). Study Design Retrospective cohort. Setting Tertiary academic referral center. Subjects and Methods Patients who underwent surgical resection for IP between 2002 and 2017. Pertinent clinical data were obtained, and all IPwCIS cases were histologically confirmed. Results In total, 37 of 215 cases (17.2%) were identified with IPwCIS. Mean age was 57 years and 86.5% of patients were male. Median follow-up was 82 months, and the recurrence rate was 27%. The maxillary sinus was the most common primary site (37.8%) and 14 tumors (37.8%) demonstrated multifocal attachment, which was associated with recurrence (odds ratio [OR], 9.7; 95% confidence interval [CI], 1.4-112.8; P = .028). IPwCIS was also associated with multiple recurrences (OR, 2.71; 95% CI, 1.246-5.814; P = .021). Most patients were treated with surgery alone (89.1%) and 4 patients received adjuvant radiotherapy (8.1%). Only 1 patient (2.7%) demonstrated malignant transformation after definitive surgery. Conclusions IPwCIS represents the most severe degree of dysplasia prior to malignant transformation and is associated with higher recurrence rate and multifocal involvement but low rate of conversion to invasive carcinoma. The need for adjuvant therapy remains controversial, and further research into the etiology of the disease is warranted.

scholarly journals Frequent Recurrence of Sinonasal Inverted Papilloma With Carcinoma In Situ in a Multifocal Attachment Pattern: A Case Report and Review of the Literature

2021 ◽  
pp. 014556132199134
Author(s):  
Yan Wang ◽  
Shunjiu Cui ◽  
Cheng Li ◽  
Bing Zhou
Keyword(s):  
Malignant Transformation ◽  
Carcinoma In Situ ◽  
Clinical Manifestations ◽  
Inverted Papilloma ◽  
Comprehensive Treatment ◽  
Invasive Squamous Cell Carcinoma ◽  
Recurrence Rates ◽  
Sinonasal Inverted Papilloma ◽  
Attachment Pattern

Sinonasal inverted papilloma (SIP) is a benign tumor originating from the nasal cavity and paranasal sinuses. Sinonasal inverted papilloma is characterized by local infiltration, high recurrence, and malignant transformation, and its associated dysplasia ranges from mild, moderate, severe, carcinoma in situ (CIS) to invasive squamous cell carcinoma. Sinonasal inverted papilloma with carcinoma in situ (IPwCIS) is the highest degree of dysplasia, which is a stage of malignant transformation of IP. Surgical excision and proper adjuvant therapy can help reduce recurrence rates and suppress further deterioration. In this study, we present a patient with IPwCIS who developed 3 recurrences with a multifocal attachment pattern in less than 18 months. We report the clinical manifestations, development, and treatment process in detail. We also performed a literature review to analyze the characteristics of the disease. Despite comprehensive treatment methods, tumor recurrence and further deterioration of IPwCIS persist.

Adenomatous polyps and carcinoma in situ of the canine colon and rectum: 34 cases (1982-1994)

1997 ◽  
Vol 33 (2) ◽  
pp. 156-160 ◽  
Author(s):  
KD Valerius ◽  
BE Powers ◽  
MA McPherron ◽  
JM Hutchison ◽  
FA Mann ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Recurrence Rate ◽  
Medical Records ◽  
Carcinoma In Situ ◽  
Clinical Signs ◽  
Adenomatous Polyps ◽  
Diffuse Disease ◽  
Colon And Rectum ◽  
Mucosal Lesions

The medical records of 34 dogs (median age, eight years) with colorectal mucosal lesions were reviewed. Hematochezia was the most common (82%) presenting sign. Most dogs (79%) presented with solitary masses located in the rectum. After histological review, 12 masses were classified as adenomatous polyps and 22 as carcinoma in situ. Recurrence of clinical signs were common (41%), and malignant transformation of the tumor was documented in 18% of the cases. A higher recurrence rate and malignant transformation occurred in dogs presented with multiple masses or diffuse disease and in dogs initially diagnosed with carcinoma in situ.

Primary temporal inverted papilloma with premalignant change

2010 ◽  
Vol 125 (2) ◽  
pp. 206-209 ◽  
Author(s):  
H Zhou ◽  
Z Chen ◽  
H Li ◽  
G Xing
Keyword(s):  
Recurrence Rate ◽  
Radical Resection ◽  
Therapeutic Strategies ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma ◽  
Sinonasal Papilloma

AbstractObjectives:To explore the pathology, diagnosis, therapeutic strategies and prognosis of primary temporal inverted papilloma.Methods:We present one of the first reported cases of primary temporal inverted papilloma with premalignant change. The available data are reviewed.Results:To the best of our knowledge, only 10 evaluable cases of this tumour have been reported. The recurrence rate is higher for this tumour than for sinonasal inverted papilloma.Conclusion:Primary temporal inverted papilloma is extremely rare, and its diagnosis should be made only following clinical exclusion of sinonasal papilloma. Therapy mainly comprises radical resection of the lesion, and long-term post-operative follow up is mandatory.

Endoscopic Surgery of a Sinonasal Inverted Papilloma: Surgical Strategy, Follow-up, and Recurrence Rate

2017 ◽  
Vol 31 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Xiao-Dan Jiang ◽  
Qing-Zhe Dong ◽  
Shen-Ling Li ◽  
Tian-Qiao Huang ◽  
Nian-Kai Zhang
Keyword(s):  
Recurrence Rate ◽  
Endoscopic Surgery ◽  
Inverted Papilloma ◽  
Surgical Strategy ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Sinonasal Inverted Papilloma ◽  
Significant Difference

Background Sinonasal inverted papilloma (SNIP) is noted for its high rate of recurrence and malignant transformation. Although many clinical studies have demonstrated the effectiveness of the endoscopic approach for SNIP, the surgical strategy has been the subject of much debate. Objective To evaluate the effectiveness of the endoscopic endonasal approach in SNIP. Methods A systematic review of patients with a diagnosis of SNIP and who had surgery at our institution from June 2005 to March 2013 was performed. All the patients who had postoperative follow-up for >2 years were enrolled. Each case was categorized into one of four stages as reported by Krouse. Demographic and tumor date, operative approach, complications, and recurrence rates were collected. Results A total of 125 patients were included in this study. There were 17 patients in stage 1, 40 in stage 2, 57 in stage 3, and 11 in stage 4. The overall recurrence rate was 8.0%. There was no significant difference in recurrence among the stages (all p > 0.05). Recurrence after endoscopic endonasal approach (8.4%) and a combined endoscopic and open exposure procedure (5.6%) were not significantly different (p > 0.05). The recurrence rate was significantly (p < 0.05) higher in patients with revision (15.6%) than in patients in the primary cases (3.8%). A common site of tumor origin was recorded to be from the maxillary sinus (40.2%). Twenty percent of recurrences were observed up to 5 years after surgery. Conclusion Endoscopic surgery may be preferred for treating SNIP. The elevated recurrence rate after revision emphasized the significance of the first surgery. We encourage a follow-up period of at least 5 years.

scholarly journals Evaluation of Correlation of Cell Cycle Proteins and Ki-67 Interaction in Paranasal Sinus Inverted Papilloma Prognosis and Squamous Cell Carcinoma Transformation

2014 ◽  
Vol 2014 ◽  
pp. 1-16 ◽  
Author(s):  
Yung-An Tsou ◽  
Hung-Jin Huang ◽  
Tang-Chuan Wang ◽  
Chih-Jaan Tai ◽  
Chuan-Mu Chen ◽  
...  
Keyword(s):  
Cell Cycle ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Malignant Transformation ◽  
Squamous Cell ◽  
Inverted Papilloma ◽  
Immunohistochemical Method ◽  
Ki 67 ◽  
Sinonasal Inverted Papilloma ◽  
Multiple Recurrences

The recurrent sinonasal inverted papilloma (IP) could be transformed to sinonasal squamous cell carcinoma. We use protein expression patterns by immunohistochemical method to see whether the expression of p53, p16, p21, and p27 belongs to cell-cycle-regulators and PCNA (proliferating cell nuclear antigen) and Ki-67 the proliferation markers in sixty patients with sinonasal inverted papilloma, and 10 of them with squamous cell carcinoma transformation. Significantly elevated levels of Ki-67, p27, and PCNA in IP with squamous cell carcinoma transformation of sinonasal tract compared with inverted papilloma were revealed. No variation of p16, p21, PLUNC (palate, lung, and nasal epithelium clone protein) and p53 expression was correlated to sinonasal IP malignant transformation by multivariate survey. However, we found elevated PLUNC expression in IPs with multiple recurrences. Finally, we found that PCNA, p27 may interact with CDK1 which promote IP cell proliferation and correlate to sinonasal squamous cell carcinoma. Ki-67 could work throughout the cell cycles to cause malignant transformation. In conclusion, this is a first study showing the correlation of Ki-67, PCNA interacted with CDK1 might lead to malignant transformation. Elevated PLUNC expression in the sinonasal IPs was related to multiple recurrences in human.

scholarly journals Clinical Analysis of 382 Sinonasal Inverted Papilloma Cases Treated at A Single Tertiary Medical Center

2020 ◽  
Vol 27 (2) ◽  
pp. 102-107
Author(s):  
Soo Kyoung Park ◽  
Geonho Lee ◽  
Min Su Kim ◽  
Yong Min Kim ◽  
Ki-Sang Rha
Keyword(s):  
Risk Factors ◽  
Recurrence Rate ◽  
Surgical Approach ◽  
Medical Center ◽  
Demographic Data ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma ◽  
Associated Malignancy ◽  
Risk Factors For Recurrence

Background and Objectives: Sinonasal inverted papilloma (IP) is a benign tumor with a locally aggressive nature and a propensity to recur. Many risk factors for recurrence have been reported, but they are still controversial. The aim of this study was to comprehensively assess the demographic data, clinical features, and potential risk factors for recurrence of IP.Subjects and Method: This work is a retrospective review of 382 patients diagnosed with and treated for sinonasal inverted papilloma between 1986 and 2017 at a single tertiary medical center. Demographic data, presence of associated malignancy, information about previous surgeries, tumor location, Krouse stage, surgical approach, follow-up duration, and data on recurrence were obtained.Results: In our study, 31 of 382 cases (8.1%) were associated with malignancy. Mean age was significantly higher in patients with associated malignancy compared to the benign IP group. Of the 351 benign cases, 263 (74.9%) were primary, and 88 (25.1%) were revision cases (residual or recurrent disease). Although the proportion of patients with high Krouse stage or multifocal involvement was high in the revision cases, there was no significant difference in recurrence rate. The 226 patients with a minimum follow-up of 1 year were included for recurrence analysis. Recurrence rate was significantly higher in the conventional surgery group (17.4%) compared to that of the endoscopic and combined surgery groups (8.1% and 3.6%, respectively). Also, the recurrence group showed significantly larger proportion of patients with high Krouse stage and multifocal involvement.Conclusion: Risk factors for recurrence of IP found in this study are comparable to those previously published. Generally, the factors associated with recurrence of IP were prior surgery, clinical stage, involved site, and surgical approach. Therefore, surgeons should always consider these risk factors to reduce the chance of recurrence.

scholarly journals Retrospective audit of sinonasal inverted papilloma at a tertiary care centre

2017 ◽  
Vol 3 (3) ◽  
pp. 517
Author(s):  
Somu L. ◽  
Prasanna Kumar S. ◽  
Urvashi Singh
Keyword(s):  
Malignant Transformation ◽  
Tertiary Care ◽  
Concurrent Chemotherapy ◽  
Inverted Papilloma ◽  
Sinonasal Tract ◽  
Female Ratio ◽  
Sinonasal Inverted Papilloma ◽  
Retrospective Audit ◽  
Total Maxillectomy

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Inverted Papilloma of the sinonasal tract is a benign neoplasm with unique locally destructive capacity, tendency to recur and a propensity for malignant change. Despite varied studies, there seems to be a lack in consensus with regards to its etiology, predictors of recurrence and malignant transformation. The aim of our study is to analyse the clinical profile, management and outcome of histopathologically proven Inverted Papilloma of the nose and paranasal sinus at our institute. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Retrospective chart review of 17 patients of histologically proven Sinonasal Inverted Papilloma over a period of 2 years from May 2013 to May 2015. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The majority were in their 5th and 6th decade of life (47%) with a male to female ratio of 15:2. All had been managed surgically with 10 patients undergoing endoscopic assisted polypectomy, 6 requiring partial maxillectomy &amp; 1 requiring total maxillectomy for complete surgical clearance. All patients had been followed up for a minimum duration of 1 year and recurrence was found in 41%. 2 patients had been diagnosed with malignant transformation during follow-up, out of which 1 underwent right partial maxillectomy along with concurrent chemotherapy and other patient underwent left total maxillectomy with concurrent chemotherapy and intensity modulated radiation therapy. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Inverted Papilloma of the sinonasal tract is a locally aggressive disease requiring careful endoscopic and radiological assessment. Adequate surgical management can ensure complete clearance of disease. A strict long term follow-up protocol will facilitate identifying recurrence and malignant transformation.</span></p><p> </p>

Breast-Conserving Treatment With or Without Radiotherapy in Ductal Carcinoma-In-Situ: Ten-Year Results of European Organisation for Research and Treatment of Cancer Randomized Phase III Trial 10853—A Study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group

2006 ◽  
Vol 24 (21) ◽  
pp. 3381-3387 ◽  
Author(s):  
Nina Bijker ◽  
Philip Meijnen ◽  
Johannes L. Peterse ◽  
Jan Bogaerts ◽  
Irène Van Hoorebeeck ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Phase Iii ◽  
Breast Conserving Treatment ◽  
European Organisation ◽  
Radiotherapy Group ◽  
Long Term Follow Up

Purpose The European Organisation for Research and Treatment of Cancer conducted a randomized trial investigating the role of radiotherapy (RT) after local excision (LE) of ductal carcinoma-in-situ (DCIS) of the breast. We analyzed the efficacy of RT with 10 years follow-up on both the overall risk of local recurrence (LR) and related to clinical, histologic, and treatment factors. Patients and Methods After complete LE, women with DCIS were randomly assigned to no further treatment or RT (50 Gy). One thousand ten women with mostly (71%) mammographically detected DCIS were included. The median follow-up was 10.5 years. Results The 10-year LR-free rate was 74% in the group treated with LE alone compared with 85% in the women treated by LE plus RT (log-rank P < .0001; hazard ratio [HR] = 0.53). The risk of DCIS and invasive LR was reduced by 48% (P = .0011) and 42% (P = .0065) respectively. Both groups had similar low risks of metastases and death. At multivariate analysis, factors significantly associated with an increased LR risk were young age (≤ 40 years; HR = 1.89), symptomatic detection (HR = 1.55), intermediately or poorly differentiated DCIS (as opposed to well-differentiated DCIS; HR = 1.85 and HR = 1.61 respectively), cribriform or solid growth pattern (as opposed to clinging/micropapillary subtypes; HR = 2.39 and HR = 2.25 respectively), doubtful margins (HR = 1.84), and treatment by LE alone (HR = 1.82). The effect of RT was homogeneous across all assessed risk factors. Conclusion With long-term follow-up, RT after LE for DCIS continued to reduce the risk of LR, with a 47% reduction at 10 years. All patient subgroups benefited from RT.

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