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Dr. Andrew Rynne

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Hi doctor! I recently had a CT scan of my

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Dr. Hari Charan Perigela

General Surgeon

Practicing since :1995

Answered : 2309 Questions

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Posted on Wed, 23 Jan 2019 in Ear, Nose and Throat Problems
Question: Hi doctor! I recently had a CT scan of my sinuses which had picked up a small soft tissue nodule in my left nasal vestibule abutting the septum and left nasal wall without evidence of erosion. I went to my ENT last month and he did a biopsy. I visited him yesterday for the results and I’m attaching a copy of the pathology report and was wondering if you could interpret it for me; of course I think of questions after I’ve left the doctor’s office. Essentially the Doctor told me it’s a shneiderian papilloma but not the inverting type. He said he wants to remove it but it is already much smaller than initially due to the biopsy plus perhaps my immune system wiping some of it out after the biopsy. He said it’s smaller than a grain of rice, and we don’t know whether HPV was the cause of it. He said it has about a seven percent chance of turning cancerous so he wants to remove it all and I have that scheduled for the end of this month. Of course, knowing me, I read the report and of course have some questions: The report didn’t specifically say which of the three subtypes it is and seems to say it has both endophytic and exophytic amd maybe even the oncocytic (?) properties. My doctor said it wasn’t the inverting type, which type do you think it is based upon the report? I guess I’m interested because I understand two of the types are usually caused by HPV and two types are more likely to turn cancerous. I understand he third type is oncocytic or something? For all intents and purposes my rational mind tells me it doesn’t really matter, because he’s removing the whole thing and seeing me for follow ups to check for reoccurrence, but part of me just needs to know the answer. Also, I’m trying to wrap my head around the fact I developed such a rare growth - do you think this is just a random occurrence and I don’t need to worry and obsess over developing more? Thank you as always for your help and kindness!!
doctor
Answered by Dr. Hari Charan Perigela 28 hours later
Brief Answer:
It is not Cancer

Detailed Answer:
Hi
I saw the reports.

Histopathological report is important. It shows that it is exophytic one, not inverted or oncocytic. Inverted and Oncocytic papillomas can turn into Cancer. The report confirms that it is only Benign growth, not cancerous.
But, it has to be removed completely and send for histopathological examination again.
The report also shows the term Dysplasia. So, it's better to remove the entire growth as early as possible.
Chances of Recurrence is less in this variety.
Nothing to worry.
It is not a rare growth. Papillomas are common in that region.
Be relaxed.

Hope I answered your query. If you have any questions,I will clarify further.
Wish you good health.
Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Hari Charan Perigela 8 hours later
Hi Dr. Perigela! Thank you so much for your kind and reassuring answer! I appreciate it so very much! I have just two additional questions:

1) I understand that these growths can be caused by the HPV virus or chronic irritation, etc. would you say that this papilloma in my nose is just a random occurrence and that I don’t have to worry about developing more of these growths in other locations?

2) I have an appointment for botox injections in my “eleven” lines between my eyebrows scheduled for two weeks before the nasal surgery. The nasal surgery is endoscopic and will be done under general anesthesia. Is it okay for me to have the botox injection done two weeks prior to that surgery?

Thank you again for your kindness!
doctor
Answered by Dr. Hari Charan Perigela 9 minutes later
Brief Answer:
HPV has to be confirmed first.

Detailed Answer:
Hi
1.To say about HPV lesions in other locations, it should be confirmed first.If you are very particular, consult your doctor and get tested for HPV.
2.Botox injections 2 weeks prior to surgery is ok.In General anaesthesia,endotracheal tube is place through the mouth.
So,no problem.
Wish you speedy recovery
Hope I answered your query.
Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Hari Charan Perigela 10 minutes later
Thank you again so much doctor! One more clarification....I’ve been tested for HPV annually with my Pap smear and have always been negative. I guess what I was concerned about was that having had this nasal papilloma (which may or may not even have been caused by HPV) doesn’t mean I should be in fear of developing more of these papillomas, does it? Is it likely it is just a random occurrence in nasal vestibule?
doctor
Answered by Dr. Hari Charan Perigela 4 minutes later
Brief Answer:
It looks like a random occurrence.

Detailed Answer:
Hi
As per your description,it looks like a random occurrence in nasal vestibule.
Nothing to worry.
It may not be seen in other locations
Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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