Rare and unusual benign tumors of the sinonasal tract and pharynx: Case series and literature review

Abstract

There are a number of benign tumors of the nose and pharynx that are seldomly reported in literature but that can sometimes prove difficult to treat and extremely important for differential diagnosis. The present study presents cases of rare benign tumors localized in the pharynx, nasal and sinus cavities, as well as reviews of literature and historical references for each type of tumor. Unilateral nasal hemangioma in a 72-year-old male which, although not a rare pathology, raised problems due to auto-resection of the tumor. The surgeon was able to pull it out with ease without bleeding; it is possible that the mass would have eventually fallen out. Pilomatrixoma is a relatively uncommon ectodermal benign tumor of the skin derived from hair matrix cells. Surgical resection is curative but recurrence is possible (≤5% risk). The presented case is of a 26-year-old female with a pilomatrixoma of the left cheek who, for aesthetic reasons, refused a classical external surgical approach. Trans-oral resection was performed, which proved feasible but laborious and prone to recurrence. Inverted Schneiderian papilloma is a rare benign tumor of the nasal and sinus cavities with increased potential for invasion, recurrence and malignant transformation compared with other types of papilloma and other benign tumors of the area. The tumor represents 0.5-4.0% of all nasal tumors and has been described under different names, such as villiform cancer and cylindrical/transitional papilloma. The present study reports a rare case of bilateral papilloma in a 68-year-old male. He presented with bilateral evolving nasal obstruction and hyposmia. Following surgery, the patient was treated by a multidisciplinary team and followed by a respiratory rehabilitation program.

Prolonged generalized osteomalacia associated with a sinonasal cavity phosphaturic mesenchymal tumor: A case report

“…The sinonasal origin of the present tumor poses further difficulties not only for the diagnosis, with several benign and malignant mimickers existing in the area, but also concerning the accessibility to obtain a biopsy and perform a complete curative excision 24 . In the sinonasal cavity, the differential diagnoses include vascular, epithelial, and mesenchymal tumors.…”

“…Fortunately, a thorough morphologic examination and negative immunostaining for cytokeratins rule out the possibility of most epithelial lesions, including those of salivary gland origin, such as myoepitheliomas. 24 Glomangiopericytomas of the sinonasal type are distinguished based on the invariable expression of SMA and desmin, along with an abnormal nuclear localization of the beta-catenin protein. Another common vascular neoplasm in the area, nasal angiofibroma, can also make the diagnosis difficult in small biopsies.…”

Unusual presentation and histopathology of bilateral nasal polypi; cavernous hemangioma (right) and inverted papilloma (left)

“…Intranasal tumors may be seen as a typical proliferative lesion with tissue destruction or may mimic an inflammatory type in the early stages, showing polyps on endoscopy 1,2 . Some of these polyps are rare and unusual and require special attention in diagnostic and therapeutic management 3 …”

Cavernous haemangioma of the nasal pyramid: literature review and our experience

“…The anatomical regions represented by the nose, paranasal sinuses and the pharynx are frequently the place of occurrence for certain tumors (benign or malignant) of different histopathological origins. However, some of these tumors are very rare, unusual, requiring special attention in diagnosis, paraclinical investigations and therapeutic approach 2 .…”

“…There are authors who have suggested that haemangioma is actually a hamartoma that derives from the development of the mesoderm, which is endothelially differentiated and then it is vascularized and canalized 10 . Environmental and clinical risk factors are not always clear, sometimes they cannot be ruled out, so clinicians must take into account that genetic susceptibility is often intensified and complicated by environmental factors 2 .…”