Alrawi M, McDermott M, Orr D, Russell J
Department of Plastic and Reconstructive Surgery, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Int J Pediatr Otorhinolaryngol. 2003 Jun;67(6):669-72. doi: 10.1016/s0165-5876(03)00067-3.
Nasal chondromesenchymal hamartoma (NCMH) is extremely uncommon primary benign cartilaginous growth of the nasal and paranasal sinuses. To date, it has been reported almost exclusively in infancy. We report a NCMH in a 16-year-old patient who presented with an asymptomatic, fixed swelling on the left side of the nose approximately 2x2 cm in size. Computed tomography (CT) and magnetic resonance imaging (MRI) of the nose, paranasal sinuses and neck confirmed a heterogeneous, calcified polypoidal mass protruding caudally into the left nasal cavity. After an initial inconclusive incisional biopsy, the patient underwent a complete radical resection, with staged reconstruction of the full nasal defect using septal mucosal flap, conchal cartilage graft and forehead skin flap. Histological examination of the resected specimen confirmed NCMH, which, we believe, had probably been present and undetected for many years. This report greatly extends the age at which NCMH may be entertained as part of the differential diagnosis of cartilaginous lesions of the nose and paranasal sinuses.
鼻软骨间叶性错构瘤（NCMH）是鼻腔和鼻窦极为罕见的原发性良性软骨生长病变。迄今为止，几乎所有病例均报道于婴儿期。我们报告一例16岁患者患有NCMH，其表现为左侧鼻部有一无症状、固定的肿胀，大小约为2×2厘米。对鼻、鼻窦和颈部进行的计算机断层扫描（CT）和磁共振成像（MRI）证实，有一个异质性、钙化的息肉样肿物向尾侧突出至左侧鼻腔。在最初的切开活检结果不明确后，该患者接受了根治性完整切除，并采用鼻中隔黏膜瓣、耳甲软骨移植和额部皮瓣分期重建全鼻缺损。对切除标本的组织学检查确诊为NCMH，我们认为该病变可能已经存在多年但未被发现。本报告极大地扩展了NCMH作为鼻腔和鼻窦软骨病变鉴别诊断一部分时所考虑的年龄范围。
