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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Carroll, G.M.A. Waters-Rist, A. and Inskip, S.A. 2016. A suspected case of intranasal inverted Schneiderian papilloma in an adult male from post-Medieval Holland. International Journal of Paleopathology, Vol. 12, p. 53.

    Agarwal, Saurabh Jagade, Mohan Borade, Avinash A, Anoop Kar, Rajesh and Bage, Sunita 2013. Use of Diode Laser in Excising Bilateral Inverted Papilloma of Paranasal Sinuses. International Journal of Otolaryngology and Head & Neck Surgery, Vol. 02, Issue. 06, p. 286.

    Sun, Chiang Lin, En-Yuan and Hung, Shih-Han 2013. Sinonasal inverted papilloma with intracranial extension. The Kaohsiung Journal of Medical Sciences, Vol. 29, Issue. 11, p. 646.

    Dingle, Isaac Stachiw, Natalka Bartlett, Anne and Lambert, Paul 2012. Bilateral inverted papilloma of the middle ear with intracranial involvement and malignant transformation: First reported case. The Laryngoscope, Vol. 122, Issue. 7, p. 1615.

    Mitchell, Candace A. Ebert, Charles S. Buchman, Craig A. and Zanation, Adam M. 2012. Combined transnasal/transtemporal management of the eustachian tube for middle ear inverted papilloma. The Laryngoscope, Vol. 122, Issue. 8, p. 1674.

    Wassef, Shafik N. Batra, Pete S. and Barnett, Samuel 2012. Skull Base Inverted Papilloma: A Comprehensive Review. ISRN Surgery, Vol. 2012, p. 1.


An unusual presentation of inverted papilloma: case report and literature review

  • V Visvanathan (a1), H Wallace (a1), P Chumas (a2) and Z G G Makura (a1)
  • DOI:
  • Published online: 03 August 2009

Inverted papilloma is a rare but locally aggressive tumour with the potential for malignant transformation. Intracranial extension or complications secondary to inverted papilloma are extremely rare. We report a case of inverted papilloma with a large frontal sinus mucocele eroding the frontal sinus, which presented with sudden neurological compromise. A literature review on intracranial extension of such tumours is also included.


A Medline search of articles, using the terms ‘inverted papilloma’, ‘Ringertz tumour’, ‘intracranial extension’ and ‘complication’. Suitable references from the collected articles were also reviewed. Articles published in English were selected and reviewed.


A total of 10 cases was identified. Intracranial spread was more commonly seen in recurrent cases, especially if the recurrence involved the cribriform plate, fovea ethmoidalis or orbits. Cases with extradural disease seemed to have a better prognosis than those with intradural spread.


Intracranial involvement of inverted papilloma is extremely rare, and is usually seen in recurrent cases. This case report highlights an unusual but serious case of inverted papilloma presenting with acute neurological deterioration secondary to a large frontal sinus mucocele eroding the frontal sinus. A literature review on intracranial extension of inverted papilloma indicated that common sites of intracranial spread include the cribriform plate, fovea ethmoidalis and orbits. The prognosis for patients with such tumours depends on the type of dural involvement, with intradural extension carrying a poorer prognosis.

Corresponding author
Address for correspondence: Mr V Visvanathan, Clinical Fellow, Department of ENT – Head and Neck Surgery, Leeds General Infirmary, Leeds, West Yorkshire, LS1 3EX, UK. E-mail:
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