Our Summary

This research paper presents a unique case of a patient with a type of nasal cancer called extramedullary nasal plasmacytoma (ENP), which developed in the same area where a nasal polyp was previously removed. This happened five months after the polyp was taken out. The patient’s tumor was completely removed through surgery, without the need for additional treatments like radiation therapy or chemotherapy. A year after the tumor removal, there were no signs of the cancer coming back, based on the results of a scope and an MRI scan. The researchers hypothesize that the cancer may have been linked to the inflammation that occurred after the polyp was removed. They also suggest that the patient’s age, and long-term exposure to viral infections and pollution, could have played a role in the development of the cancer by causing changes in the patient’s B-cells, a type of white blood cell.

FAQs

  1. What is extramedullary nasal plasmacytoma (ENP)?
  2. Could the removal of a nasal polyp lead to the development of ENP?
  3. What factors may contribute to the development of ENP after the removal of a nasal polyp?

Doctor’s Tip

A helpful tip a doctor might tell a patient about nasal polyp removal is to follow post-operative care instructions carefully to prevent complications and promote proper healing. This may include avoiding activities that could irritate the nasal passages, such as blowing your nose too forcefully or engaging in strenuous exercise. It is also important to keep the nasal passages moisturized with saline nasal sprays or rinses to help reduce inflammation and promote healing. Additionally, regular follow-up appointments with your doctor are important to monitor for any signs of recurrence or complications.

Suitable For

Patients who are typically recommended nasal polyp removal are those who are experiencing symptoms such as:

  • Nasal congestion
  • Runny nose
  • Postnasal drip
  • Decreased sense of smell
  • Facial pain or pressure
  • Headaches

In cases where nasal polyps are causing severe symptoms that do not improve with medication, surgery may be recommended. Additionally, patients with recurrent nasal polyps or those who have nasal polyps that are blocking the nasal passages may also be candidates for surgical removal.

In the case of the patient with ENP discussed in the research paper, the development of nasal cancer after nasal polyp removal was a rare and unexpected occurrence. This highlights the importance of close monitoring and follow-up care for patients who have undergone nasal polyp removal, to ensure that any potential complications or new developments are promptly addressed.

Timeline

Before nasal polyp removal:

  1. Patient experiences symptoms such as nasal congestion, difficulty breathing through the nose, reduced sense of smell, postnasal drip, and facial pain or pressure.
  2. Patient undergoes a physical examination and nasal endoscopy to diagnose the nasal polyps.
  3. Treatment options are discussed, including medications to reduce inflammation and shrink the polyps, or surgical removal if conservative measures are ineffective.

After nasal polyp removal:

  1. Surgery is performed to remove the nasal polyps, typically through endoscopic sinus surgery.
  2. Patient may experience mild discomfort, nasal congestion, and bloody discharge in the days following the surgery.
  3. Follow-up appointments are scheduled to monitor healing and check for any signs of recurrence.
  4. Patient gradually experiences improved nasal breathing, sense of smell, and overall quality of life.
  5. In some cases, complications such as infection, bleeding, or recurrence of polyps may occur, requiring additional treatment.
  6. Long-term follow-up is recommended to monitor for any potential complications or recurrence of nasal polyps.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with nasal polyp removal surgery?
  2. How long is the recovery period after nasal polyp removal surgery?
  3. Will I need any additional treatments or medications following the removal of the nasal polyps?
  4. Are there any lifestyle or dietary changes I should make to prevent the recurrence of nasal polyps?
  5. How often should I follow up with you after the surgery to monitor for any signs of recurrence or complications?
  6. Is there a possibility that the removal of my nasal polyps could lead to the development of other conditions, such as cancer, in the future?
  7. What symptoms should I watch out for that may indicate a complication or recurrence of nasal polyps after surgery?
  8. Are there any specific precautions I should take after the surgery to promote healing and reduce the risk of complications?
  9. Are there any alternative treatments or therapies that I should consider in addition to or instead of surgery for nasal polyp removal?
  10. What can I do to reduce inflammation and prevent the development of nasal polyps in the future?

Reference

Authors: Di Stadio A, Gambacorta V, de Crescenzo S, Sidoni A, Cristi MC, Di Giovanni A, Maranzano M, Ricci G. Journal: Mol Clin Oncol. 2020 May;12(5):451-455. doi: 10.3892/mco.2020.2007. Epub 2020 Feb 26. PMID: 32257202