Clinical and molecular pathology of aggressive Schneiderian papilloma involving the temporal bone

Background. Inverting papilloma is a benign but locally aggressive sinonasal tumor that rarely involves the middle ear or temporal bone. Methods. A report of a case and the molecular pathology of the tumor is presented. Results. A 35-year-old woman with a history of recurrent inverting papilloma of the left paranasal sinuses was found to have evidence of extension through the eustachian tube and extensive involvement of the temporal bone. Surgical management resulted in the patient being disease- free at 14 months. Molecular pathology studies of the resected tumor suggest an association with human papillomavirus. Conclusions. Direct extension of the sinonasal tumor through the eustachian tube may represent the pathologic mechanism involved in the development of inverting papilloma involving the middle ear and temporal bone.