Inverted Papilloma of the Orbit and Nasolacrimal System
| Autor: | Jee-Young Moon, Katherine G. Gold, Cat N. Burkat, Neda Esmaili, Gregory J. Griepentrog, Morris E. Hartstein, Paul D. Langer, Parag Gandhi, Jessie Wang, Steven M. Couch, Kathleen Duerksen, Joshua Ford, Anne Barmettler, John Nguyen, Rachel K. Sobel, Bita Esmaeli |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population Inverted papilloma Malignancy 03 medical and health sciences 0302 clinical medicine Medicine Humans education Retrospective Studies education.field_of_study Papilloma Inverted Nasolacrimal duct business.industry Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Radiation therapy Ophthalmology medicine.anatomical_structure 030221 ophthalmology & optometry Papilloma Female Neoplasm Recurrence Local business Nasolacrimal Duct Orbit Paranasal Sinus Neoplasms Orbit (anatomy) |
| Zdroj: | Ophthalmic plastic and reconstructive surgery. 37(2) |
| ISSN: | 1537-2677 |
| Popis: | Purpose Periocular inverted papilloma (IP) is a rare, locally aggressive tumor with a propensity for recurrence and malignant transformation. Historically treated via wide excision, this study examines the characteristics and management of periocular IP, comparing those confined to the nasolacrimal system with those invading the orbit. Methods An Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective, comparative case series was conducted in patients with IP of the orbit or nasolacrimal system across 15 clinical sites. Results Of 25 patients, 22 met inclusion criteria with 9 limited to the nasolacrimal system and 13 invading the orbit. Mean age was 60.4 years, 55% were women, all were unilateral. Mean follow-up was 48 months. Rates of smoking, dust and/or aerosol exposure, human papillomavirus (HPV) status, and inflammatory polyps were elevated compared to rates in the general population (45%, 18%, 18%, and 14%, respectively). Bony erosion on computed tomography scans was statistically significantly associated with orbit-invading IP (p = 0.002). Treatment involved all confined IP undergoing surgery alone while 39% of orbit-invading IP also received radiation therapy and/or chemotherapy (p = 0.054). Orbit-invading IP was more likely to be excised with wide margins than IP confined to the nasolacrimal system (85% vs. 22%, p = 0.007). Overall rates of malignancy, recurrence, and patient mortality from IP were found to be 27%, 23%, and 9%, respectively. Conclusions IP invading the orbit typically requires aggressive therapy, while IP confined to the nasolacrimal system may be treated more conservatively. Using risk factors, characteristics, and outcomes, a treatment algorithm was created to guide management. |
| Databáze: | OpenAIRE |
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