The clinicopathological and radiological features of unilateral nasal mass in adults, a tertiary hospital experience
Keywords:Clinicopathological, Unilateral nasal mass, Neoplastic pathology
Background: Aim and objectives of the study were to analyze and study the diverse presentations of unilateral nasal mass and to identify the suggestive features of neoplastic pathology in adult’s population at a tertiary referral hospital.
Methods: A retrospective analysis of 90 patients presented with unilateral sinonasal mass, reported to the Rhinology and Skull Base Clinic at the department of ENT in King Fahad Specialist Hospital, Dammam. The parameters include patient history, clinical assessments and histopathological examinations, which were supplemented with radiological investigations.In addition, demographic information and histopathological examinations for patients, who underwent surgical excision was analyzed for correlation with clinical diagnosis.
Results: The reported cases are 55 males and 35 females with a median follow-up period of 12 months, ranging from 2-72 months. Nasal obstruction is the major symptom 34 (38%), 25 (27.8%) cases were reported with nasal mass and clinical diagnosis indicates 18 (20%) cases of malignancy. Type of disease and gender demonstrates low significance (p=0.023), whereas the diagnosis with age is highly significant (p=0.005).
Conclusions: Carcinoma, inflammatory polyposis, inverted papilloma and allergic fungal sinusitis were the highest histological diagnosis. The clinical diagnosis and the suggestive features of radiological findings mostly resembled the histological findings. In contrary to the resemblance, the histological finding reveals the general diagnosis of nasal mass to the precise diagnosis, especially the fatal conditions like carcinoma. The high rate of malignancy and its suggestive radiological findings indicates that the specialists should consider the cases with caution to carryout histological analysis to rule out the probability of neoplasm.
Hedman J, Kaprio J, Poussa T, Nieminen MM. Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol. 1999;28(4):717-22.
Settipane GA. Epidemiology of nasal polyps. Allergy Asthma Proc. 1996;17(5):231-6.
Drake-Lee AB. Nasal polyps. In: Kerr AG, Mackay IS, Bull TR (eds). Scott-Brown’s Otolaryngology, Vol. 4: Rhinology, 6th ed. Butterworth-Heinemann, Oxford, 1997; 4/10/1–16.
Drake-Lee AB, Lowe D, Swanston A, Grace A. Clinical profile and recurrence of nasal polyps. J Laryngol Otol. 1984;98(8):783-93.
Drake-Lee AB. Nasal polyps. Hosp Med, 2004;65:264-7.
Irfan M, Shamim AK. Routine histological examination for nasal polyp specimens: is it necessary? Med J Malaysia. 2009;64(1):59-60.
Safadi A, Carmel-Neiderman NN, Toledano R, Ungar OJ, Mokh FA, Wengier A, et al. The Efficiency of Routine Histopathological Examination for Bilateral Nasal Polyposis. Ear Nose Throat J. 2019:145561319872728.
Klossek JM, Neukirch F, Pribil C, Jankowski R, Serrano E, Chanal I, et al. Prevalence of nasal polyposis in France: a cross-sectional, case-control study. Allergy. 2005 Feb;60(2):233-7.
Jessen M, Malm L. Definition, prevalence and development of nasal obstruction. Allergy. 1997;52(40 Suppl):3-6.
Olszowiec-Chlebna M, Trzciński K, Stelmach I. Massive nasal polyposis in a patient with newly diagnosed cystic fibrosis. Adv Respir Med. 2017;85(2):121-3.
Şahin B, Sönmez S, Kara H, Aydemir L, Çomoğlu Ş. A Rarely Seen Mass of Nasal Cavity: Seromucinous Hamartoma. J Craniofac Surg. 2019 .
Pino Rivero V, González Palomino A, Pardo Romero G, Marcos García M, Trinidad Ruíz G, Pantoja Hernández CG, et al. Nasal polyposis masquerading epidermoid carcinoma of the maxillary sinus. Importance of the biopsy in FENS. An Otorrinolaringol Ibero Am. 2005;32(2):187-92.
Maina IW, Tong CCL, Baranov E, Patel NN, Triantafillou V, Kuan EC, et al. Clinical Implications of Carcinoma In Situ in Sinonasal Inverted Papilloma. Otolaryngol Head Neck Surg. 2019;161(6):1036-42.
Akbay E, Özgür T, Çokkeser Y. Is there any relationship between the clinical, radiological and histopathologic findings in sinonasal polyposis? Turk Patoloji Derg. 2013;29(2):127-33.