Our Summary

A 45-year-old man who had been suffering from chronic nasal congestion in his left nostril went to the doctor. The doctor performed a nasal endoscopy and found a small, stalk-like growth in the back of the man’s nasal cavity. A CT scan confirmed the presence of this growth, which was about 1 inch in size. The doctors performed surgery through the nose to remove this growth, ensuring they removed a bit of extra tissue around it for safety.

The growth was identified as a seromucinous hamartoma, a very rare kind of benign (non-cancerous) tumor. Only 31 cases of this kind of tumor have been reported. The first-choice treatment for this type of tumor is surgery performed through the nose. However, it’s important to differentiate this kind of tumor from other types of growths, such as inflammatory polyps, respiratory epithelial adenomatoid hamartoma, and adenocarcinoma, which is a type of cancer.

While seromucinous hamartoma is not cancerous, there have been cases where it has transformed into adenocarcinoma. Thus, it’s crucial that any growth found in one side of the nose is correctly diagnosed.

FAQs

  1. What is a sinonasal seromucinous hamartoma (SH)?
  2. What is the first-line treatment for sinonasal SH?
  3. Can a sinonasal seromucinous hamartoma progress to adenocarcinoma?

Doctor’s Tip

A helpful tip a doctor might tell a patient about nasal polyp removal is to follow post-operative care instructions carefully, including avoiding blowing your nose forcefully, keeping the nasal passages clean with saline rinses, and attending follow-up appointments to monitor for any recurrence of polyps. It is also important to report any new or worsening symptoms to your doctor promptly.

Suitable For

Patients who are typically recommended nasal polyp removal include those with chronic nasal congestion, pedunculated polypoid masses, large mass-like growths attached to the nasal septum, and tumors with glandular epithelium surfaces. In cases where the tumor is suspected to be a rare sinonasal seromucinous hamartoma (SH), surgical removal is often recommended as the first-line treatment to prevent progression to adenocarcinoma. Additionally, patients with unilateral posterior nasal tumors should undergo precise diagnosis to rule out other differential diagnoses such as inflammatory polyps or adenocarcinoma.

Timeline

  • Patient presents with chronic left nasal congestion
  • Nasal endoscopy reveals pedunculated polypoid mass on posterior nasal septum
  • Computed tomography reveals 25mm mass-like growth in left posterior nasal cavity attached to nasal septum
  • Patient undergoes transnasal endoscopic surgery for removal of tumor
  • Final pathological diagnosis is sinonasal seromucinous hamartoma
  • Differential diagnoses include inflammatory polyps, respiratory epithelial adenomatoid hamartoma, and adenocarcinoma
  • Transnasal endoscopic surgery is first-line treatment for sinonasal SH
  • Sinonasal SH is a rare tumor with only 31 reported cases
  • Progression to adenocarcinoma has been reported in some cases
  • Unilateral posterior nasal tumors must be diagnosed precisely

What to Ask Your Doctor

  1. What are the risks and benefits of nasal polyp removal surgery?
  2. What is the expected recovery time after nasal polyp removal surgery?
  3. Will I need any follow-up appointments or treatments after the surgery?
  4. How likely is it that the nasal polyps will come back after removal?
  5. Are there any lifestyle changes or medications I should consider after the surgery to prevent nasal polyps from returning?
  6. What should I do if I experience any complications or side effects after the surgery?
  7. How will nasal polyp removal surgery affect my sense of smell and taste?
  8. Are there any alternative treatment options for nasal polyps that I should consider?
  9. Will I need any imaging tests or biopsies before the surgery to confirm the diagnosis of the nasal polyps?
  10. Can you explain the specific type of nasal polyps that I have and how common or rare it is?

Reference

Authors: Ito S, Ide T, Ishikawa K, Hashizume A, Matsumoto F, Higo R. Journal: Ear Nose Throat J. 2023 Nov 22:1455613231213496. doi: 10.1177/01455613231213496. Online ahead of print. PMID: 37991209