Historical Aspects

In 1854, Ward1 first described a nasal papilloma. Billroth reported on a recurring nasal papilloma 1 year later, which he called villi-form cancer; many others began to look at this peculiar entity that appeared to invert,1-6 as examined microscopically. In his landmark paper in 1971, Hyams1 clarified the confUsion regarding the characteristic growth behavior of IP by demonstrating the prognostic significance of certain histologic features. Hyams showed that increased mitotic activity, hypercellularity, pleomorphism, and atypia are associated with more aggressive and recurrent tumors. Furthermore, these histologic findings are associated with an increased tendency toward synchronous and metachronous carcinoma. When surface keratinization and dyskeratosis are found, there is increased suspicion for squamous cell carcinoma.1

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