Site of Origin

The middle turbinate and medial maxilllary sinus wall are the most common sites of origin of IP.8 A single focus is the most likely source of the tumor. Multicentricity was documented in only 7 of 149 cases by Hyams1 and in 10 of 29 cases by Norris.3 These findings would support the conclusion that incomplete excision is the cause of recurrence, and not delayed development of IP at another site. As for the paranasal sinuses, the ethmoid and maxillary sinuses are the major sinuses involved. Only 1% of cases involve the frontal sinuses. In rare cases, the tumor can be isolated to the sphenoid sinus.28 Paranasal sinus involvement has been linked to an increased

recurrence rate.

However, this adverse association has been demonstrated in recent small studies to be surmountable with endoscopic sinus surgery. Furthermore, the sinuses tend to become involved secondary to nasal cavity tumors. Suh et al.12 showed that in 49 of 57 cases both the nasal cavity and paranasal sinuses were involved; in only 2 of 59 cases was the sinus involved exclusively.

Histology

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