Inverted Papilloma of the Bulla Ethmoidalis: An Uncommon Epicenter for a Benign Yet Aggressive Tumor
Ainin Zahidah Binti Kamal Zuhairi *
Department of ORL-HNS, Hospital Tengku Ampuan Afzan, Jalan Tanah Putih, 25100 Kuantan, Pahang, Malaysia.
Khairul Azhar Bin M. Rajet
Department of ORL-HNS, Hospital Tengku Ampuan Afzan, Jalan Tanah Putih, 25100 Kuantan, Pahang, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Inverted papillomas are benign tumours known for their locally aggressive behaviour, characterised by local tissue destruction, a high tendency to recur if resection is incomplete, and a risk of carcinomatous evolution into squamous cell carcinoma. Although most cases arise from the nasal wall and paranasal sinuses, inverted papillomas originating from the bulla ethmoidalis are exceedingly rare. We report the case of a 67-year-old man who presented with progressive right-sided nasal obstruction and rhinorrhoea. Imaging and histopathological findings confirmed the diagnosis of inverted papilloma arising from the right bulla ethmoidalis. Surgical excision was performed, and complete resection was achieved. The patient had an uneventful postoperative recovery, and follow-up will be crucial for monitoring potential recurrence. This case highlights the importance of early recognition, appropriate imaging, and thorough surgical planning in managing inverted papillomas, particularly in rare locations such as the bulla ethmoidalis, to ensure optimal outcomes and reduce the risk of recurrence and malignancy.
Keywords: Inverted papilloma, bulla ethmoidalis, mulberry-like mass, focal hyperostosis