Management of FDG avid Benign Sinonasal Schneiderian Papilloma: A Case Report and Review of the Literature.
BACKGROUND
The inverted and oncocytic subtypes of sinonasal Schneiderian papillomas are benign tumors with possible rare malignant transformation and are typically managed with complete surgical resection and close follow-up. While computed tomography (CT) and magnetic resonance imaging (MRI) are mainstays in preoperative evaluation of bony invasion and soft tissue extension of the lesion, their imaging characteristics by 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) is less well characterized.


OBJECTIVE
To describe the clinical presentation and management of a PET positive sinonasal lesion. To conduct a literature review of FDG uptake in benign sinonasal papillomas.


METHODS
Case report (n = 1) and literature review of similar cases (n = 32).


RESULTS
We report the case of a 69-year-old man presenting with an isolated left maxillary sinus mass with avid FDG uptake, discovered on PET/CT imaging. An endoscopic left maxillary mega-antrostomy provided successful definitive treatment for final pathologic diagnosis of oncocytic papilloma. Literature review of cases of sinonasal papillomas with avid FDG uptake found that oncocytic papillomas, on average, exhibit greater uptake than inverted papillomas and both may be mistaken as malignancies on PET.


CONCLUSION
While PET imaging demonstrating avid FDG uptake is associated with an increased risk of malignancy, it does not rule out the possibility of a benign sinonasal papilloma nor other benign inflammatory lesions. Particularly, oncocytic papillomas may have very high FDG uptake and mimic malignant lesions.
['Shafqat|Iram|I|', 'Ho|Allen S|AS|', 'Manzoor|Daniel|D|', 'Balzer|Bonnie|B|', 'Wu|Arthur W|AW|https://orcid.org/0000-0001-8993-6355']
D018249:Adenoma, Oxyphilic D000368:Aged D003937:Diagnosis, Differential D019788:Fluorodeoxyglucose F18 D006801:Humans D008297:Male D008444:Maxillary Sinus Neoplasms D009297:Nasal Mucosa D009369:Neoplasms D018308:Papilloma, Inverted D000072078:Positron Emission Tomography Computed Tomography D011300:Preoperative Care D019275:Radiopharmaceuticals
FDG Schneiderian papilloma PET oncocytic papilloma inverted papilloma cylindrical papilloma endoscopic sinus surgery nasal tumor sinonasal tumor