30 March 2020 : Case report
Choanal Polyp with Osseous Metaplasia: Radiological and Therapeutic Management of a Rare Case and a Review of Bone Metaplastic Lesions of Sinonasal Tract
Challenging differential diagnosis, Diagnostic / therapeutic accidents, Rare coexistence of disease or pathology
Domenico Testa1AD, Michele Nunziata1BEF, Maria Loreto Romano1B, Eva A. Massimilla1B, Giorgio Toni2BD, Generoso De Cristofaro1B, Giuseppina Marcuccio1EF*, Gaetano Motta1ADDOI: 10.12659/AJCR.921494
Am J Case Rep 2020; 21:e921494
Abstract
BACKGROUND: Osseous metaplasia is a heterotopic normal bone in soft tissues. It is occasionally found in mucosal polyps of the external auditory canal, tongue, gut, stomach, nasal cavity, and uterus. Choanal polyp with osseous metaplasia originating from the lateral wall of the nasopharynx has not been previously reported. In fact, osseous metaplasia in nasal polyps represents a very uncommon histological finding with only 12 cases described in the literature.
CASE REPORT: We reported here, the clinical, radiological, and therapeutic management of a nasopharynx choanal polyp in a patient with severe nasal obstruction and rhinolalia history. Endoscopic examination of nasal cavities revealed a polypoid-like mass in the left nasal fossa, extending to the choanal area and nasopharynx. Computed tomography scan and contrast-enhanced magnetic resonance imaging confirmed the presence of a solitary and lobulated mass in the choanal area and nasopharynx. We performed the removal of the mass through careful hemostasis of left sphenopalatine artery using both transnasal and transoral paths, with no complications for the patient. Histopathological examination of the biopsy revealed a benign inflammatory polyp with osseous metaplasia. No recurrence was noted 24 months after surgery.
CONCLUSIONS: The incidence of ossifying areas in nasal polyps is very low, with only 12 cases reported in the literature. Ossifying polyps originating from the lateral wall of nasopharynx has never been reported before. The use of a combined endoscopic and transoral surgical approach was shown to be reliable in terms of adequate exposure and visualization of the lesion, control of bleeding, and complete removal of the mass.
Keywords: Bone Neoplasms, Metaplasia, Nasal Polyps, Nasal Obstruction, Nasopharynx
In Press
Case report
Concurrent Diagnosis of Chronic Lymphocytic Leukemia and Plasma Cell Myeloma: Report of 2 Cases and Differe...Am J Case Rep In Press; DOI: 10.12659/AJCR.944707
Case report
“No-Touch” Saphenous Vein Grafting and Coronary Aneurysm Ligation in an Adult Patient with Suspected Prior ...Am J Case Rep In Press; DOI: 10.12659/AJCR.945431
Case report
Unexpected Chylous Ascites During Umbilical Hernia Repair in a Patient with Necrotizing Pancreatitis: A Cas...Am J Case Rep In Press; DOI: 10.12659/AJCR.944609
Case report
A Rare Complication of Cannabinoid Hyperemesis SyndromeAm J Case Rep In Press; DOI: 10.12659/AJCR.945106
Most Viewed Current Articles
21 Jun 2024 : Case report 57,146
Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...DOI :10.12659/AJCR.944371
Am J Case Rep 2024; 25:e944371
07 Mar 2024 : Case report 42,303
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report 32,415
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
23 Feb 2022 : Case report 19,841
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250