Title: Locally Aggresive Nasal Polyp Masquerading As A Malignant Mass – A Case Report
Authors: Dr Divyashree, Dr Rajesh Kumar Saket, Dr Pallovie Singh, Dr Surabhi Mehrotra, Dr Arjun Raju P
DOI: http://dx.doi.org/10.18535/jmscr/v3i8.17
DIDS : 08.2015-99586973
Angiomatous nasal polyp (ANP) is a rare entity of inflammatory sinonasal polyp, constituting 4 to 5% of all nasal polyps1,2. Without knowledge of the typical clinical presentation and the complete study of imaging findings, the entity tends to be clinically and radiologically confused with neoplastic processes and even malignancy.5 Their diagnosis and management requires more detailed evaluation in respect to classical antrochoanal polyps. In both antrochoanal polyps and angiomatous nasal polyps, bone destruction is seen as a rare exceptional finding. We present an interesting case of angiomatous nasal polyp. CT finding also supported the clinical impression of neoplastic mass but biopsy was negative for malignancy. The biopsy confirmed the final impression of angiomatous nasal polyp. Angiomatous antrochoanal polyps are rare variants that require special attention both at diagnosis and during surgery. The signs of bone destruction and epistaxis suggest additional pathologies including inverted papilloma, lobular capillary haemangioma and carcinoma as differential diagnoses. Keywords: Antrochoanal polyp, Angiomatous nasal polyp, Bone destruction 1. Jumpei Nota, Yasuyuki Hinohira, Hirotaka Takahashi, Futoshi Watanabe, Kiyofumi Gyo. Angiectatic nasal polyp localized in the maxillary sinus. Japanese J of Rhinology 2008;47(2): 105-08. 2. YfantisHG, DrachenberyCB, GrayW, et al. Angioectatic nasal polyps that clinically simulate a malignant process: report of 2 cases and review of the literature. Arch Pathol Lab Med 2000;124: 423–26 3. Sinha SN. Observations on histology of nasal polyps. Indian J of Otolaryngol and Head &Neck Surg May2007;19(4):164-68. 4. Ceylan A, Asal K, Celenk F, Uslu S. An angiomatous nasal polyp:a very rare variant of sinochoanal nasal polyps. B ENT 2007; 3:145-7. 5. Sheahan P, Crotty PL, Hamilton S, Colreavy M, McShane D.Infarcted angiomatous nasal polyps. Eur Arch Otorhinolaryngol ;2005; 262: 225-30. 6. Yfantis HG, Drachenberg CB, Gray W, Papdimitriou JC. Angiectatic nasal polyps that clinically simulate a malignant process: Report of two cases and review of literature. Archives of Pathol Lab Med Mar 2000;124(3):406-10. 7. Batsakis J, et al. Tumors of head and neck: Clinical and 7. Batsakis JG, Sneige N. Choanal and angiomatous polyps of pathological considerations (2nd ed). Baltimore: Williams and sinonasal tract. Ann Otol Rhinol Laryngol 92;101:623-25. 8. Park CS, Noh H, Bae SC, Park YJ. Antrochoanal polyp is variant, the angiomatous nasal polyp: A case report. Korean J Otolaryngol Head and Neck Surg Apr 2006;49(4):443-46. 9. Sheahan P, Crotty PL, Hamilton S, Colreavy M, McShane D. Infarcted angiomatous nasal polyps. Eur Arch Otolaryngol 2005;262:225-30. 10. Batsakis JG, Sneige N. Choanal and angiomatous polyps of sinonasal tract. Ann Otol Rhinol Laryngol 92;101:623-25. 11. Sayed RH, Abu-Dief EE. Does antrochoanal polyp presents with epistaxis? B-ENT 2007;3(3):145-47. 12. De Vuysere S, Hermans R, Marchal G. Sinonasal polyp and its variant-the angiomatous polyp: MRI findings. Eur Radiol 2001;11(1):55-58. 1. 13. Som P, Cohen B, Sacher M. The angiomatous polyp and the angiofibroma: Two different lesions. Radiology 1982;144: 329-34. 14. BatsakisJG, SneigeN. Choanal and angiomatous polyps of the sinonasal tract. Ann Otol Rhinol Laryngol 92;101:623-25 15. 12. Iwata N, Hattori K, Nakagawa T, Tsujimura T (2002) Hemangioma of the nasal cavity: a clinicopathologic study. Auris Nasus Larynx29: 335–339 [PubMed] 16. 13. Lee DK, Chung SK, Dhong HJ, Kim HY, Kim HJ, et al. (2007) Focal hyperostosis on CT of sinonasal inverted papilloma as a predictor of tumor origin. AJNR Am J Neuroradiol28: 618–621 [PubMed] 17. 14. Mafee MF, Tran BH, Chapa AR (2006) Imaging of rhinosinusitis and its complications: plain film, CT, and MRI. Clin Rev AllergyImmunol30: 165–186 [PubMed] 18. 15. Rudralingam M, Jones K, Woolford TJ (2002) The unilateral opaque maxillary sinus on computed tomography. : Br J Oral Maxillofac Surg40: 504–507 [PubMed]Abstract
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