Intracranial extension of inverted papilloma: An unusual and potentially fatal complication

Background. The purpose of this article is to define the outcome of intracr anial extension of inverted papilloma and outline a rationale for managemen t of this rare clinical presentation. Methods. A review of patients with intracranial extension of inverted papil loma reported in the literature (18 patients), or treated in our institutio n (3 patients) was performed. The data of these 21 patients were consolidat ed with regard to clinical presentation, treatment, and outcome. Nine patie nts, including 1 of our cases, had coexisting squamous cell carcinoma and t herefore were excluded from the analysis. Twelve patients with "pure" inver ted papilloma formed the basis of this study. Results. The majority of patients (83%) with intracranial inverted papillom a had recurrent disease. Patients with extradural disease had a survival ra te of 86% with an average follow-up of 4.4 years. Eighty-six percent of the se survivors were treated with craniofacial resection. In contrast, 75% of patients with intradural inverted papilloma were dead of disease with an av erage follow-up of 9.3 months regardless of the treatment modality. Conclusions. Intracranial extension of inverted papilloma is mostly associa ted with recurrent disease. Intracranial extradural inverted papilloma can be effectively controlled with craniofacial resection. Intracranial intradu ral involvement of inverted papilloma has a poor prognosis regardless of tr eatment. Aggressive treatment of intranasal inverted papilloma may be the m ost important factor in preventing intracranial presentation. (C) 1999 John Wiley & Sons, Inc. Head Neck 21: 703-706, 1999.