Hairy Polyp, a Clinicopathologic Study of Four Cases

Abstract

Hairy polyps (HPs), dermoids or teratoid tumors are rare tumors of naso-oropharyngeal region which commonly present at or shortly after birth. The etiology and classification of these tumors is still debatable and categorized by different authors differently. HPs have female predominance and usually present with respiratory and feeding problems. Microscopically, the polyp is covered by skin with underlying mesenchymal core. The aim of this study is to describe the clinicopathological features of Hairy polyps on a cohort of cases. We reviewed the surgical pathology database of our institution for last 10 years and retrieved four cases of hairy polyps. The age of patients ranged from 1 month to 18 years (mean = 12 years), with a female to male ratio of 1:3. Two of our cases presented at birth and two cases in late teens. Two of the HPs were located in nasopharynx, one on soft and hard palate and one on lower lip. One case was associated with bifurcation of tongue. Size of the polyps ranged from 2.3 to 4.5 cm (mean = 3 cm). Histologically, all HPs were lined by skin and the underlying core consisted of adnexal structures, adipocytes, skeletal muscle, smooth muscle and seromucinous glands. Lymphoid aggregates, cartilage and bone were seen in one case each. Our series highlights the diverse nature of this entity in terms of age of presentation and location. HP at lower lip and associated bifurcation of tongue has not been previously reported. We observed a male predominance in contrast to the published literature. However, number of cases is too few to read a definite conclusion on this point. The etiology is still controversial and includes congenital malformation and activation of pluripotent stem cells.

Oropharyngeal Dermoid Cyst in an Infant with Intermittent Airway Obstruction

“…In contrast to epidermoid cysts, dermoid cysts typically do not show restricted diffusion. Dermoid cysts in the oropharyngeal cavities may present with respiratory distress and feeding difficulties as in our patient 6 . Other symptoms include hearing loss, otorrhea, vomiting, earache, bleeding, snoring, and recurrent ear infections 6 .…”

“…Neuroimaging allows the differentiation of dermoid cysts from other lesions within the oropharynx such as meningoencephalocele, heterotopic neuroglial tissue, glioma, and craniopharyngioma (Figure 2) 1,6 . This differentiation is essential in terms of surgical management and outcome.…”

Adult nasopharyngeal hairy polyp presenting with middle ear effusion

“…Naso-oropharyngeal HPs typically seen in female neonates with left sided predominancy while they are extremely rare in adult population [10,13]. We present the 6 th case of adult nasopharyngeal HP with an uncommon presentation.…”

Hairy Polyp of the Nasopharynx Arising from the Eustachian Tube

“…Hairy polyps of the nasopharynx most commonly arise from the lateral wall or superior aspect of the pharynx, but can also arise from the hard and soft palates, tonsils, tongue, Eustachian tube, and middle ear [1][2][3][4]. Hearing loss, otorrhea and otitis media can occur if the lesion arises from Fig.…”

“…In the literature, terms such as dermoid, hamartoma, teratoma, and choristoma have been used interchangeably to describe hairy polyps. However, histopathologically, hairy polyps are comprised of mesodermal and ectodermal derivatives and are perhaps most appropriately characterized as dermoids [4]. The mesenchymal components often include fat and cartilage, while the outer ectodermal layer is comprised of a keratinizing squamous epithelial layer with adnexal structures, such as hair follicles, hence the term hairy polyp.…”