All of the following are true about inveed papilloma except

Inveed papilloma is most commonly seen in men in the age group of 40- 70 than women. It arises from the lateral wall of the nose in the middle meatus and is almost always unilateral. Human papilloma virus is thought to be responsible for this condition. Wider external surgical approaches may be required for tumour extending to the frontal sinus or orbit. Recurrence can occur. Ref: Textbook of diseases of ENT; PL Dhingra; 7th edition, pg no. 227