Nasopharyngeal hamartoma: importance of routine complete nasal examination

Abstract

The authors report clinical experience in managing an 82-year-old female presenting with long-standing bilateral nasal obstruction resulting from a nasopharyngeal mass. The patient had undergone a number of treatments including surgery. The previous examinations, investigations and treatment had all been performed within the previous 10 years and although examination had been documented there was no evidence on review of the notes that the nasopharynx had been inspected either by nasendoscopy or indirectly. The mass was removed via a combined nasal and oral approach. Histopathological examination of the specimen was consistent with mesenchymal hamartoma. In addition to describing a rare presentation the authors believe this case highlights the importance of complete examination in all patients with nasal symptoms.

Nasal vascular hamartoma in a Domestic Shorthair cat

“…The pathogenesis remains incompletely understood, but an inflammatory process has been suggested as an initiating factor for tumorigenesis 14–16,18,19 . In the present case, the clinical signs (epistaxis, respiratory tract obstruction and facial deformity) parallel those reported for human patients with nasopharyngeal hamartomata of several different types 5,14–16,18,20 …”

“…The term was coined by Willis, 3 who considered it an essential feature that the lesion be obviously of developmental origin. However, many entities called ‘hamartoma’ fail to meet Willis's strict guidelines and a looser, generally acceptable definition is ‘a self‐limiting growth, present at birth, whose growth increases normally and ceases with maturity’ 4,5 …”

Imaging of nasopharyngeal cysts and bursae

“…16) are in close connection with the sinusal cavities [49]; teratoma (Fig. 17) and hamartoma have a fatty content [50,51]; mucocele of the sphenoid sinus is an expansile non-enhancing mass that may reach the nasopharynx by osteolysis of the sinus floor.…”

Nasopharyngeal leiomyomatous hamartoma: case report

“…Hamartomas are non-neoplastic overgrowth of mature/differentiated tissue indigenous to the specific part of the body in which they develop [1]. Most hamartomas are located in the liver [2], spleen [3], lungs [4], and pancreas [5], although several hamartomas in the nasopharynx have been reported [1,6,7].…”

“…Most hamartomas are located in the liver [2], spleen [3], lungs [4], and pancreas [5], although several hamartomas in the nasopharynx have been reported [1,6,7]. Hamartomas are classified as epithelial, mesenchymal, or mixed epithelial and mesenchymal types.…”