An inverted papilloma, also known as Ringertz tumour, is a type of

tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

in which surface

epithelial cells Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercell ...

grow downward into the underlying supportive tissue. It may occur in the nose and/or

sinuses Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity. The maxillary sinuses are located under the eyes; the frontal sinuses are above the eyes; the ethmoidal sinuses are between the eyes and the sphenoid ...

or in the

urinary tract The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, con ...

(

bladder The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters ...

renal pelvis The renal pelvis or pelvis of the kidney is the funnel-like dilated part of the ureter in the kidney. It is formed by the covnvergence of the major calyces, acting as a funnel for urine flowing from the major calyces to the ureter. It has a mucous ...

ureter The ureters are tubes made of smooth muscle that propel urine from the kidneys to the urinary bladder. In a human adult, the ureters are usually long and around in diameter. The ureter is lined by urothelial cells, a type of transitional epit ...

urethra The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra con ...

). When it occurs in the nose or sinuses, it may cause

symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an disease, illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormali ...

similar to those caused by

sinusitis Sinusitis, also known as rhinosinusitis, is inflammation of the nasal mucosa, mucous membranes that line the paranasal sinuses, sinuses resulting in symptoms that may include thick Mucus#Respiratory system, nasal mucus, a nasal congestion, plugg ...

, such as

nasal congestion Nasal congestion is the blockage of nasal breathing usually due to membranes lining the nose becoming swollen from inflamed blood vessels. Background In about 85% of cases, nasal congestion leads to mouth breathing rather than nasal breathing. ...

. When it occurs in the urinary tract, it may cause

blood in the urine Hematuria or haematuria is defined as the presence of blood or red blood cells in the urine. “Gross hematuria” occurs when urine appears red, brown, or tea-colored due to the presence of blood. Hematuria may also be subtle and only detectable w ...

Diagnosis

Inverted papillomas are definitively diagnosed by histologic examination. However, magnetic resonance imaging (MRI) may show a characteristic feature described as a convoluted cerebriform pattern (CCP). A retrospective study published in the ''American Journal of Neuroradiology'' concluded that identification of CCP by MRI in a patient with a nasal tumor made the diagnosis of Inverted papilloma quite likely. The study reported the sensitivity and specificity to be 100% and 87% respectively. CCP can be associated with other malignant tumors as well.

Treatment

Medial maxillectomy is the treatment of choice.

History

Inverted papillomae were first described by Nils Ringertz in 1938. He reported their microscopic appearance and their tendency to grow into the connective tissue stroma.

Additional images

File:Bladder inverted papilloma histopathology (1).jpg, Histopathology representing an inverted papilloma of the urinary bladder that was cystoscopically resected. Hematoxylin and eosion stain. File:Bladder inverted papilloma histopathology (2).jpg, Histopathology representing an inverted papilloma of the urinary bladder that was cystoscopically resected. Hematoxylin and eosion stain. File:Bladder inverted papilloma histopathology (3).jpg, Histopathology representing an inverted papilloma of the urinary bladder that was cystoscopically resected. Hematoxylin and eosion stain. File:Inverted Schneiderian Papilloma of the Nasal Cavity (8116183976).jpg, Inverted Schneiderian Papilloma of the

Nasal Cavity The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal c ...

. File:Inverted Schneiderian Papilloma of the Nasal Cavity (8116184172).jpg, Inverted Schneiderian Papilloma of the Nasal Cavity with Abundant intraepithelial microabscesses.

References

External links

Inverted papilloma
entry in the public domain NCI Dictionary of Cancer Terms Benign neoplasms Nose disorders Urological neoplasia {{oncology-stub