Angiectatic nasal polyp diagnostic quandary of sinonasal malignancy
Keywords:Inflammatory nasal polyp, Sinonasal tumour, Pseudoneoplastic
Angiectatic nasal polyp (ANP) is a rare entity of inflammatory nasal polyp accounts for only 4 to 5% of all nasal polyp.It is often misdiagnosed as a malignant neoplasm due to its aggressive clinical presentation and radiological findings mimicking a neoplastic characteristic. achieving the diagnosis of ANP can be a challenge but crucial as management and prognosis of malignant and benign sinonasal tumour differs significantly. We describe a unique case of an ANP in a 33 year old gentleman presented with left sided nasal obstruction associated with blood stained nasal discharge, facial pain and left eye epiphora. There was proptosis of the left eye and his left nasolabial fold was obliterated due to a vague left cheek swelling. Clinical presentation was highly suspicious of malignancy. CT scan finding was also suggestive of malignant tumour with surrounding bony bowing and erosions, while MRI was reported as haemangioma. Post-surgery of left endoscopic medial maxillectomy, histopathology result was negative for malignancy. After revision of specimen done and further discussions, the diagnosis of ANP was made. Patient was postoperatively well with regression of symptoms along 5 months follow-up. ANPs are relatively uncommon pseudoneoplastic lesion that can cause a significant diagnostic dilemma as illustrated in this case. awareness of distinctive radiological and histopathological findings of ANP is important to establish the diagnosis and managed accordingly. However, little is known to guide the approach in such cases, therefore we find the case report to be noteworthy in this field.
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