Angiomatoid Nasal Polyp. Often Misdiagnosed and Little Known Lesion. Report of 45 Cases.
Ladislav Hadravsky, Alena Skalova, Michal Michal. Charles University in Prague, Czech Republic
Background: Background: Angiomatoid nasal polyps (ANP) arising from inflammatory nasal polyps are benign lesions with frequent recurrences. Inflammatory nasal polyps may become partially or extensively infarcted which results in hemorrhage, necrosis and erosion of the surrounding tissues including the skeletal bones. These changes in ANP may cause the histological resemblance to various benign and malignant tumors of nasal and perinasal regions and cause misdiagnosis which may lead to destructive therapeutic approach.
Design: Design: 45 cases of Pilsner consultation registry (32 men and 13 women) were accessed to the registry between 1994-2010 were retrieved. The follow-up was available in 27 patients.
Results: Results: The average age of patients when ANP detected was 49 (13-84) years in men and 54.3 (18-83) years in women. The most common reported symptoms were: recurrent epistaxis (21/27), obstruction (16/27), secretion of mucus and pus (5/27), and pain located to the paranasal sinuses (3/27). The average size of ANPs was 25,71 (5-80) mm. Most frequent locations were: nasal septum (14/41), antrum Highmori (12/41), ethmoid sinuses (5/41) lateral wall of nasal cavity (5/41), sphenoid sinus (1/41), and non-specific nasal cavity (4/41). X-ray or computed tomography scans were performed in 19 cases and bone erosions/deviations occurred in 4/4 cases of them. Allergies were found in 44% (11/25) patients. Most common allergies reported were: dust, mites, pollen, hey, honey, ATBs, nuts, chlorine, and cold. Six patients had a history of cancer (endometrial adenocarcinoma, rectal carcinoma, colonic carcinoma, carcinoma of kidney, lymphoma, and plasmacytoma and cutaneous basal cell carcinoma). Initial misdiagnoses submitted by referring pathologists were reported in 20/45 cases (angiofibroma 32%, hemangioma 24%, hemangiopericytoma 16%, angiosarcoma 12%, pyogenic granuloma and hemangioendotelioma- both at 8%). None of the patients died of the disease and there has been no progression in any patient. Recurrence was recorded in 30% (9/30).
Conclusions: Conclusion: This study confirms that ANPs are benign, often recurring lesions, likely to be confused with other tumorous lesions of sinonasal region by pathologists, which may lead to useless destructive therapeutic approach. There are no clinicopathologic studies describing these lesions available in the literature, which contributes to the rate of misdiagnoses.
Category: Head & Neck
Wednesday, March 2, 2011 9:30 AM
Poster Session V # 142, Wednesday Morning