Sinonasal angiomatous polyp: a case report
Keywords:SAP, Maxillary sinus, Endoscopic sinus surgery
Sinonasal angiomatous polyp (SAP) is a rare variant of sino-nasal polyp. Sinonasal inflammatory polyps are classified histo-pathologically into 5 types: edematous, glandular, fibrous, cystic and angiomatous. They present with various different patterns and clinical features like epistaxis, nasal discharge, nasal blockage and characterised histo-pathologically by presence of prominent dilated capillary-type blood vessels. It constitutes about 4-5% of all nasal polyps. They usually present as a unilateral, painless, soft, gelatinous, translucent and polypoidal mass in nasal cavity. These polyps can grow rapidly and aggressively causing erosion of bone and severe bleeding like a cancerous lesion, making difficult to differentiate it from malignant lesion. Various differential diagnosis of SAP include inflammatory polyp, haemangioma, mucocele, fungus ball, inverted papilloma, juvenile naso-pharyngeal angiofibroma, and malignant tumors like squamous cell carcinoma, adenoid cystic carcinoma, and melanoma MRI is considered better than CT scan for diagnosis. Treatment of choice is endoscopic surgical excision with restoration of sinus drainage.
Peric A, Jovanovski A, Vukomanovic B. Giant angiomatous choanal polyp originating from the middle turbinate: a case report. ENT Updates. 2017;7(1):53-6.
Assiri KS, Al-Ahmari MS, Alshahrani MS. Clinical and Pathological Features of Angiomatous Nasal Polyps: A Report of Four Cases and Review of Literature. Cureus. 2020;12(4):e7642.
Sheahan P, Crotty PL, Hamilton S, Colreavy M, McShane D. Infarcted angiomatous nasal polyps. Arch Otorhinolaryngol. 2005;262:225-30.
Dai LB, Zhou SH, Ruan LX, Zheng ZJ. Correlation of computed tomography with pathological features in angiomatous nasal polyps. PLOS One. 2012;7:53306.
Yfantis HG, Drachenberg CB, Gray W, Papadimitriou JC. Angiectatic nasal polyps that clinically simulate a malignant process: report of 2 cases and review of the literature. Lab Med. 2000;124:406-10.
Idris AI, Ramli RR, Sachlin IS. Angiomatous antrochoanal polyps: Challenge in diagnosis: Egypt J Ear Nose Throat Allied Sci. 2017;18(2):137-9.
Changwei D, Wang Q, Guo Q, Wang Z, Lu X, Zhang J. Sinonasal Angiomatous Polyp. Medicine. 2015;94(29):e1196.
Tam Y, Wu C, Lee T, Lin Y, Chen T, Huang C. The clinicopathological features of sinonasal angiomatous polyps. Int J Gen Med. 2016;9:207-12.
Bhama LK, Soni NK. Angiomatous Antrochoanal Polyp Causing Epistaxis and Bone Destruction. Clin Rhinol An Int J. 2018;11(1):25-8.