Abstract

Pharyngeal inverted papilloma is rare. To the best of our knowledge, we present the first case of an extranasal pharyngeal inverted papilloma with parapharyngeal space invasion and associated hearing loss and the first literature review on the features of this lesion. A 77-year-old man presented with leftsided hearing loss and a sore throat. Left-sided otitis media with effusion, a mass in the right nasal cavity, and a mass in the left nasopharynx were identified. Pure-tone audiography revealed left-sided mixed conductive-sensorineural hearing loss. Magnetic resonance imaging showed a tumor in the left nasopharynx that extended into the fossa of Rosenmüller and parapharyngeal space. His pathological diagnosis was bilateral inverted papillomas. Our literature review showed that pharyngeal inverted papilloma occurs most frequently in the nasopharynx (65.4%), followed by the oropharynx (30.8%) and hypopharynx (3.8%). The symptoms include sore throat, foreign body sensation, and hearing loss. Approximately 50% patients are asymptomatic and diagnosed during other examinations or treatments. The lesions are generally surgically excised, with recurrence and malignant transformation rates of 31.6% and 15.4%, respectively. Histopathology showed koilocytes in our patient. Human papilloma virus DNA has never been investigated in pharyngeal inverted papilloma; further studies are warranted to elucidate the etiology.