Sinonasal respiratory epithelial adenomatoid hamartoma: An overlooked entity

Saniasiaya, Jeyasakthy; Shukri, Norasnieda Md; Ramli, Ramiza Ramza; Wahab, Wan Nor Najmiyah Wan Abdul; Zawawi, Norzaliana

doi:10.1016/j.ejenta.2016.12.014

Cited by 5 publications

(8 citation statements)

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“…They typically arise in the third to ninth decades of life, with a male predominance (3:2), similar to the age and gender of our patient, but the location was different in our patient as it originated from the nasal roof [11]. They also tend to occur unilaterally, unlike our case in which it was bilateral [12]. Nasal obstruction, rhinorrhea, epistaxis, recurrent chronic rhinosinusitis, facial pain, and hyposmia/anosmia are some of the symptoms of the disease [9].…”

Section: Discussionsupporting

confidence: 58%

An atypical presentation of a Respiratory Epithelial Adenomatoid Hamartoma, a case report

Al-Musaileem

Qazi

Bastaki

et al. 2019

Annals of Medicine and Surgery

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IntroductionRespiratory Epithelial Adenomatoid Hamartoma (REAH) is a benign disease that can resemble other malignant entities. Thus, it is essential to diagnose it accurately as the treatment approach differs, from radical surgeries in malignant cases, to a simple excision in hamartoma. We present an unusual case of bilateral REAH that was misdiagnosed, and hence it was treated aggressively.Case reportA 57-year-old male patient presented with anosmia, 2-years history of bilateral nasal obstruction, and was accompanied with a moderate headache. An impression of olfactory neuroblastoma was made after history taking physical examination, and imaging studies. The patient underwent Functional Endoscopic Sinus Surgery (FESS), excisional biopsy of the cribriform plate mass bilaterally, and superior septectomy. Histopathologic examination of the bilateral masses showed sinonasal polyposis with crypting of surface mucosa and pseudoglandular formation. A diagnosis of sinonasal polyps with REAH was established. The patient's nasal obstruction improved, with no recurrence of sinusitis ± polyposis. However, he still complains of anosmia after 2-years follow-up.ConclusionAlthough REAH is a benign disease, it is critical to reach the correct diagnosis, in order to avoid aggressive treatment. Unfortunately, the preoperative investigations were not consistent with REAH, thus it was misdiagnosed and treated aggressively.

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Section: Discussionsupporting

confidence: 58%

An atypical presentation of a Respiratory Epithelial Adenomatoid Hamartoma, a case report

Al-Musaileem

Qazi

Bastaki

et al. 2019

Annals of Medicine and Surgery

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“…Approximately 70% of the tumours are found in the nasal cavity (Kessler and Unterman, 2004;Saniasiaya et al, 2017), most often derived from the posterior part of the nasal septum (Gauchotte et al, 2013;Kessler and Unterman, 2004;Saniasiaya et al, 2017;Rom et al, 2018;Bignami et al, 2014). The diagnosis was first described in 1995 by Wenig and Heffner (Saraniti et al, 2018;Gauchotte et al, 2013;Kessler and Unterman, 2004;Goh et al, 2018;Saniasiaya et al, 2017;Rom et al, 2018;Bignami et al, 2014;Al Hawat et al, 2015;Safi et al, 2019) and was introduced in the WHO classification of tumours of the head and neck in 2005 (Bignami et al, 2014;Safi et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…The aetiology remains unknown (Saraniti et al, 2018;Kessler and Unterman, 2004;Saniasiaya et al, 2017;Rom et al, 2018;Bignami et al, 2014;Al Hawat et al, 2015;Safi et al, 2019), but inflammation is thought to contribute to the development of REAH (Kessler and Unterman, 2004;Saniasiaya et al, 2017;Rom et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Most cases of REAH occur in adult patients in the 5th or 6th decade of life (Gauchotte et al, 2013;Kessler and Unterman, 2004) with male predominance (Saraniti et al, 2018;Gauchotte et al, 2013;Kessler and Unterman, 2004;Goh et al, 2018;Saniasiaya et al, 2017;Rom et al, 2018;Bignami et al, 2014;Al Hawat et al, 2015). The symptoms are sparse and diffuse (Saraniti et al, 2018;Kessler and Unterman, 2004;Saniasiaya et al, 2017;Bignami et al, 2014), and typically include one or more of the following: nasal obstruction, recurrent rhinosinusitis, epistaxis, hyposmia, or headache (Gauchotte et al, 2013;Kessler and Unterman, 2004;Goh et al, 2018;Rom et al, 2018;Bignami et al, 2014;Al Hawat et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Complete local resection of the tumour is the treatment of choice (Saraniti et al, 2018;Kessler and Unterman, 2004;Goh et al, 2018;Saniasiaya et al, 2017). Recurrence after complete resection is very rare (Gauchotte et al, 2013;Goh et al, 2018;Rom et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Unilateral Nasal Obstruction by Respiratory Epithelial Adenomatoid Hamartoma

Mikkelsen¹,

Zainali-Gill²

2020

FMCR

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Respiratory epithelial adenomatoid hamartoma is a rare benign tumour involving the nasal cavity, paranasal sinuses or rhinopharynx. The tumour most often arises from the posterior part of the nasal septum.We report a case of nasal obstruction throughout a 25-30 year period in a 74-year-old woman caused by a respiratory epithelial adenomatoid hamartoma originating from the uncinate process. The tumour was surgically excised whereby dramatically improving air passage through the nose.Biopsies from pathologies in the nasal cavity is important to get a definite diagnosis and distinguish benign from malignant tumours. A biopsy verified diagnosis of REAH is important prior to plan the extent of surgical excision of this benign lesion to avoid unnecessary aggressive surgery and associated complications such as anosmia, orbital or skull base trauma with risk of orbital haematoma, blindness, cerebrospinal fluid leak and meningitis.

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