Background: Sinonasal inverted papillomas (IP) are uncommon and are particularly rare in children. We present a case of recurrent nasal IP in a child and review its characteristic radiographic and histologic appearance, then suggest an appropriate management and surveillance strategy. Methods: Review the clinical, radiologic and histopathologic findings of nasal IP in a child and review cases of pathologically confirmed pediatric IP in the English literature. Results: A 9 year old girl presented with recurrent left sided nasal obstruction and rhinorrhea following two prior resections of a left nasal mass. Nasal endoscopy revealed a papillomatous lesion in the left nasal cavity. The lesion was resected endoscopically with negative margins. Histological examination showed an inverted Schneiderian papilloma. Review of the English literature identified fewer than 20 cases of IP in children. One case of squamous cell carcinoma arising from an IP in a 20-year-old patient has been reported. IP demonstrates a high propensity for recurrence if inadequate excision is performed. No clinical or pathologic features seem to distinguish pediatric IP from adult IP. Conclusions: IP, while most commonly found in adults, can occur in children as well. Clinical and radiographic findings mimic other benign sinonasal pathologies; therefore, diagnosis is based on histopathology either via biopsy or following surgical excision. As has been advocated in adults, we propose complete endoscopic resection of unilateral papillomatous sinonasal masses in children and close long-term surveillance for recurrence.
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