鼻窦乳头状瘤(SP),以前的Schneiderian乳头状瘤,代表一组罕见的良性上皮肿瘤,最常见于鼻窦,虽然在咽部不太常见,泪囊,中耳。颞骨鼻窦型乳头状瘤(TBSP),与在鼻窦发现的那些相比,似乎有更高的复发和恶变风险。根据这份临床报告和对英文文献中报道的病例的回顾,57例中有49%发生在并发或先发鼻窦或鼻咽SP的情况下。性别分布平等(26名女性和31名男性),报告年龄范围很广(19-81岁)(中位数56岁;平均54岁)。3例患者有双侧疾病。症状包括伴有听力损失的肿块病变,中耳炎,耳漏,耳痛,和耳鸣,在其他人中。在42例患者中发现反向SP,六个嗜酸细胞性SP,和外生SP中的四个(其余未定义)。49例随访患者中有38例(78%)复发,通常随着时间的推移多次复发,19例(33%)颞骨癌,男性患癌症的比例为女性的1.7:1。手术是首选的治疗方法(根治性乳突切除术),有6例(10%)死于疾病(中位数30个月,平均38个月),而47例患者在最后一次随访时仍存活:31例无疾病(平均33个月);7例有局部复发疾病(平均20个月);9例患者存活但疾病状态未知;4例无随访.总之,在并发鼻窦道疾病的背景下,经常发现TBSP,与鼻窦道相似的组织学特征。没有性偏好,患者最常见于生命的第六个十年。反复发作很常见,与鼻窦道乳头状瘤相比,癌的发展频率更高(33%),但认识到癌可能在任何一个或两个解剖部位都有记录。总体结果很好,有必要进行长期临床随访以治疗复发或恶变。
Sinonasal papilloma (SP), formerly Schneiderian papilloma, represents a rare group of benign epithelial neoplasms, most commonly identified in the sinonasal tract, while less frequently identified in the pharynx, lacrimal sac, and middle ear. Within temporal bone sinonasal-type papilloma (TBSP), there seems to be a much higher recurrence and malignant transformation risk than those identified in the sinonasal tract. Based on this clinical report and a review of the cases reported in the English literature, 49% of the 57 cases developed in the setting of concurrent or antecedent sinonasal or nasopharyngeal SP. There is an equal sex distribution (26 females and 31 males), with a broad age range (19-81 years) at presentation (median 56 years; average 54 years). Three patients had bilateral disease. Symptoms include a mass lesion with hearing loss, otitis media, otorrhea, otalgia, and tinnitus, among others. Inverted SP was identified in 42 patients, oncocytic SP in six, and exophytic SP in four (undefined in the remainder). Recurrence was identified in 38 of 49 patients with follow-up (78%), often with multiple recurrences over time, with carcinoma developing in the temporal bone in 19 patients (33%), with males developing carcinoma by a 1.7:1 ratio over females. Surgery was the treatment of choice (radical mastoidectomy) with 6 patients (10%) dead of disease (median 30 months, mean 38 months), while 47 patients were alive at last follow-up: 31 without disease (mean 33 months); 7 with locally recurrent disease (mean 20 months); 9 patients alive but with unknown disease status; and 4 patients without follow-up. In conclusion, TBSP is frequently identified in the setting of concurrent sinonasal tract disease, showing similar histologic features to sinonasal tract counterparts. There is no sex predilection, with patients most commonly presenting in the sixth decade of life. Recurrences are common, with carcinoma developing much more frequently than in sinonasal tract papilloma (33%), but recognizing that carcinoma may be documented in either or both anatomic sites. Overall outcome is excellent, with long term clinical follow-up warranted to manage recurrence or malignant transformation.