악성변화를 동반한 반전성 유두종의 임상적 고찰

Background and Objectives: Inverted Papilloma is a benign neoplastic lesion which shows high recurrence rate and possibility of association with malignacy. Squamous cell carcinoma arising in inverted papilloma has been reported in the literature. But most reported series have very few patients with this disease. This report was conducted to investigate clinical characteristics and treatment outcome of squamous cell carcinoma arising in inverted papilloma. Materials and Methods: We reviewed clinical data of eight patients who have been treated from January 1982 to March 1998 for squamous cell carcinoma arising in inverted papilloma. Results: Synchronus tumor was 6 cases and metachronus tumor was 2 cases. The most common presenting symptom was unilateral nasal obstruction. Others were nasal bleeding, rhinorrhea, and periorbital swelling with eyeball deviation. Stage at diagnosis was according to modified Kadish staging system, 5 cases of B stage, 1 of C stage and 2 of D stage. All patients were treated with surgical excision and postoperative radiation therapy was done in 6 cases. In 2 cases, postoperative radiation therapy was not performed because they refused radiation therapy. In case of stage B, all lived more than 3 years and prognosis was better than C stage. Conclusion: We suggest that modified Kadish staging system is more helpful than maxillary carcinoma staging system in prediction of prognosis of squamous cell carcinoma arising in inverted papilloma. We recommend wide surgical excision in squamous cell carcinoma and long term follow up period after inverted papilloma operation due to the possibility of metachronus. (J Clinical Otolaryngol 1999;10:66-70)