Schneiderian papillomas and carcinomas: A review

The ectodermally derived Schneiderian mucosa gives rise to an extremely var ied collection of benign and malignant neoplasms. Prototypical of these are the Schneiderian papillomas (inverted, fungiform, and cylindrical cell) an d their malignant counterparts. Human papilloma virus (HPV) is currently th e leading candidate as a cofactor in the pathogenesis of the papillomas. Ca rcinomas arise in association with the papillomas in about a 10% frequency. The carcinomas may be synchronous or metachronous. Recurrences of the papi llomas are the bane of surgeons. The magnitude of the recurrences is direct ly proportional to the completeness of removal with the best results obtain ed by techniques that afford the best operative exposure. A comparison of r esults by different surgical procedures is presented. Histologic features s ought to predict recurrences or malignant transformation have, by and large , not been helpful. Keratinization and hyperkeratosis in papillomas, howeve r, are suggested to be sufficiently ominous as to warrant further study.