An inverted papilloma, also known as Ringertz tumour, is a type of

tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

in which surface epithelial cells grow downward into the underlying supportive tissue. It may occur in the nose and/or

sinuses Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity. The maxillary sinuses are located under the eyes; the frontal sinuses are above the eyes; the ethmoidal sinuses are between the eyes and the sphenoi ...

or in the urinary tract (

bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distens ...

renal pelvis The renal pelvis or pelvis of the kidney is the funnel-like dilated part of the ureter in the kidney. It is formed by the convergence of the major calyces, acting as a funnel for urine flowing from the major calyces to the ureter. It has a mucous ...

ureter The ureters are tubes composed of smooth muscle that transport urine from the kidneys to the urinary bladder. In an adult human, the ureters typically measure 20 to 30 centimeters in length and about 3 to 4 millimeters in diameter. They are lin ...

urethra The urethra (: urethras or urethrae) is the tube that connects the urinary bladder to the urinary meatus, through which Placentalia, placental mammals Urination, urinate and Ejaculation, ejaculate. The external urethral sphincter is a striated ...

). When it occurs in the nose or sinuses, it may cause

symptoms Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

similar to those caused by

sinusitis Sinusitis, also known as rhinosinusitis, is an inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include production of thick nasal mucus, nasal congestion, facial congestion, facial pain, facial pressure ...

, such as

nasal congestion Nasal congestion is the partial or complete blockage of nasal passages, leading to impaired nasal breathing, usually due to membranes lining the nose becoming swollen from inflammation of blood vessels. Background In about 85% of cases, nasal ...

. When it occurs in the urinary tract, it may cause blood in the urine.

Diagnosis

Inverted papillomas are definitively diagnosed by histologic examination. However, magnetic resonance imaging (MRI) may show a characteristic feature described as a convoluted cerebriform pattern (CCP). A retrospective study published in the ''American Journal of Neuroradiology'' concluded that identification of CCP by MRI in a patient with a nasal tumor made the diagnosis of Inverted papilloma quite likely. The study reported the sensitivity and specificity to be 100% and 87% respectively. CCP can be associated with other malignant tumors as well.

Treatment

The treatment of choice in sinus and nose is by Functional endoscopic sinus surgery.

Recurrence and malignification

Inverted papillomas of the sinus and nose have a high risk of recurrence after surgical treatment. The recurrence often occurs within 2 years after the surgery and at the initial anatomical site . Inverted papillomas have a potential for malignant transformation in 5-15%.

History

Inverted papillomae were first described by Nils Ringertz in 1938. He reported their microscopic appearance and their tendency to grow into the connective tissue stroma.

Additional image

File:Bladder inverted papilloma histopathology (1).jpg, Histopathology representing an inverted papilloma of the urinary bladder that was cystoscopically resected. Hematoxylin and eosion stain. File:Bladder inverted papilloma histopathology (2).jpg, Histopathology representing an inverted papilloma of the urinary bladder that was cystoscopically resected. Hematoxylin and eosion stain. File:Bladder inverted papilloma histopathology (3).jpg, Histopathology representing an inverted papilloma of the urinary bladder that was cystoscopically resected. Hematoxylin and eosion stain. File:Inverted Schneiderian Papilloma of the Nasal Cavity (8116183976).jpg, Inverted Schneiderian Papilloma of the

Nasal Cavity The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nas ...

. File:Inverted Schneiderian Papilloma of the Nasal Cavity (8116184172).jpg, Inverted Schneiderian Papilloma of the Nasal Cavity with Abundant intraepithelial microabscesses.

References

External links

Inverted papilloma
entry in the public domain NCI Dictionary of Cancer Terms Benign neoplasms Nose disorders Urological neoplasia {{oncology-stub