Sinonasal Inverted Papilloma: A Case Report from Mali

Abstract

Inverted papilloma (IP) or also called Schneiderian Papilloma is an unusual and rare type of nasal tumor. Generally benign, but can have osteolytic powers and the possibility of transformation into malignancy during its evolution. Several hypotheses emerge in the literature, however the most frequent remains viral origin with the involvement of human papillomavirus (HPV). This is a case of bilateral inverted papilloma in a 60-year-old male patient at the Reference Health Center of the VI commune of the Bamako-Mali district. The symptoms appeared about 14 months ago, marked by a bilateral anterior rhinorrhea, of gradual appearance, associated with nasal obstruction, epistaxis, headaches and anosmia. Thus the diagnosis was made using physical examination and additional examinations such as the scanner of the facial massif, the anatomopathological examination of the operating room, and the test of the human papillomavirus, which turned out to be positive for HPV16 and HPV18. The management consisted of endonasal surgery, with the complete macroscopic removal of the mass and an average meatotomy accompanied by two years of follow-up after the surgical procedure. Since the PI is an aggressive tumor, its management must require long-term surveillance due to the possibility of recidivism and malignant degeneration finally to act early for these eventualities.