Abstract Listings 2024

Purpose

We present the clinical features of the case, the pertinent sequential findings on clinical review, histological images from biopsy and radiological images showing the extent of the tumour. We discuss the epidemiology, signs and symptoms and management of inverted papilloma.

Methods

Case report

Results

Introduction
Periocular inverted papilloma is a rare locally aggressive tumour with a tendency to recurrence and risk of malignant transformation.

Case Report
A 68-year-old man presented with a right upper lid lesion present for 3 months. The patient was managed as for canaliculitis with canaliculotomy and instillation of levofloxacin.
Follow up at 3 months showed a papillomatous lesion extending from the right upper canaliculus causing obstruction and epiphora. The patient underwent a biopsy of the lesion and a further canaliculotomy.
Histology showed a squamous papillomatous lesion with high grade dysplasia.
MRI of the head showed a 31x30x25mm homogenously enhancing mass occupying the sella and right sphenoid sinus with extension into the cavernous sinuses and right optic canal.

Conclusion

Discussion
Nasolacrimal involvement of inverted papilloma is a rare entity. A lesion centred on the sphenoid sinus is rarer still with a nonspecific and insidious presentation. Typical, unique MRI findings are hypodensity on T1, iso- or hypodensity on T2, contrast enhancement, and convoluted cerebriform pattern. Management requires a multidisciplinary approach, the aim is to achieve complete resection while preserving anatomy and function. Long-term surveillance is indicated as there is significant evidence for late recurrence.

Conclusion
It is important to consider the diagnosis of inverted papilloma in nasolacrimal and orbital disease.
Imaging of the head and orbits is essential for the management of inverted papilloma confirmed on histology.

Additional Authors

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