Primary Inverted Papilloma of the Middle Ear.

Significance Statement: Primary middle ear inverted papilloma is an exceedingly rare finding posing a diagnostic challenge, as symptomatology often mimics common clinical entities like serous otitis media. Clinical and radiological findings are not specific, whilst high recurrence rates, local destruction, and potential malignant transformation constitute an overall demanding surgical challenge, requiring aggressive procedures. We report the case of a primary inverted papilloma of the middle ear, discussing diagnostic and therapeutic issues.