A Sneak Peek into the Biological Behavior of Sinonasal Papillary Neoplasms – A Study of 12 Cases

A BSTRACT Background and Objectives: Sinonasal papillary neoplasms include benign and malignant tumors of the sinonasal tract. Benign sinonasal papillary neoplasms are papillomas which further have three subtypes: exophytic, inverted, and oncocytic. Malignant sinonasal neoplasms include a broad spectrum of malignancies. The two most common malignancies are Carcinoma ex-Sinonasal papilloma and sinonasal adenocarcinoma. The objective of the study performed is to illustrate the clinical presentations, histopathologic patterns, and biological behavior of sinonasal papillary neoplasms. Material and Methods: A retrospective study was performed on cases of sinonasal neoplasms diagnosed during the study period after procuring institutional ethical committee clearance. The clinical, pathologic, and follow-up details were retrieved from the hospital records and the pathology database and were analyzed. Results: Ten cases of sinonasal papillomas and one case each of Carcinoma ex-Sinonasal papilloma and sinonasal adenocarcinoma were studied. Sinonasal papillomas had a mean age of 54.6 years with female preponderance and most commonly presenting with unilateral nasal obstruction. It included three subtypes: exophytic (n = 2), inverted papilloma (n = 7), and oncocytic papilloma (n = 1). Malignant sinonasal neoplasms included Carcinoma ex-Sinonasal papilloma and sinonasal adenocarcinoma in a 78-year-old female with unilateral nasal obstruction and a 68-year-old male, respectively, presenting with nasal bleed. Conclusion: Inverted sinonasal papilloma is most common. Malignant transformation of sinonasal papillomas is rare. Endoscopic resection is the treatment of choice for papillomas, whereas for sinonasal malignancies, resection is performed depending on the extent of anatomic involvement. The biological behavior of these entities is different, emphasizing the importance of precise diagnosis for appropriate management.