Author(s)
Stefano Millarelli, MD
Marina Colzi, MD
Theodoros Varakliotis, MD
Francesca Romana Millarelli, MS
Gianluca Bellocchi, MD
Affiliation(s)
San Camillo Forlanini Hospital
Abstract:
We analyzed the case histories of 530 consecutive Functional Endoscopic Sinus Surgery performed at our institution for chronic rhinosinusitis and found a multiform variety of unexpected aggressive benign/malignant disease as a result of standard histologic examination, starting from various locations in the naso-sinusal area.Definitive histology consisted of 45 inverted papillomas, 3 NH lymphomas, 1 minor salivary carcinoma, 2 ethmoid adenocarcinoma, 8 polyps from inclusion of amorphous material, 7 mycetomas.The analysis showed an origin prevalence of the inverted papillomas in the maxillary sinuses, while the distribution of the remaining neoplastic disease is uneven.Patients age was between 20 and 84 years. Prior to surgery all patients underwent CT scan of paranasal sinuses and MR in suspected cases: despite that, in some cases where CT was not particularly engaged the histological result was not consistent.Therapy was obviously wide different depending on the histology: hadron therapy, chemotherapy, peace meal endoscopic resection followed by radiation therapy, reoperation in case of uncomplete resection/recurrence of the inverted papilloma. While usually woodworkers are at high risk for sinonasal carcinoma, in the 2 cases in this serie we didn’t find any correlation with this risk factor.All patients are alive without disease with a mean follow-up of 4 years except 1 case of lymphoma and 1 case of nasal carcinoma which are died.We can therefore confirm the importance of histologic examination in all cases presenting with also marginal, undefinite suspect clinical/radiological signs to avoid dangerous risk of misdiagnosis and uncorrect treatment.