Braun H, Beham A, Stammberger H
Hals-, Nasen-, Ohren-Universitätsklinik Graz, Austria.
Laryngorhinootologie. 2003 Jun;82(6):416-20. doi: 10.1055/s-2003-40540.
Hamartomas are tumour-like malformations, resulting from excessive proliferation of otherwise normal local tissue components. Hamartomas of the nasal cavity and paranasal sinuses are relatively rare, especially respiratory epithelial adenomatoid hamartomas. This benign lesion is characterized by a glandular proliferation originating from the surface of the respiratory epithelium. In the German speaking literature this entity has not been described before.
We report the case of a 51-year-old white female, presenting with a respiratory epithelial adenomatoid hamartoma of her left nasal cavity. The patient suffered from nasal obstruction. The CT scan showed a soft tissue like lesion obstructing the patient's left choana. After local resection of the tumour, which originated from the superior turbinate through functional endoscopic sinus surgery the patient's symptoms were gone. Follow-up after six months showed no evidence of recurrence.
The histopathological differential diagnosis of respiratory epithelial adenomatoid hamartomas includes inverted papilloma and adenocarcinoma. Therefore the histological recognition of these hamartomas impacts on therapy. Misinterpretation as a true neoplasm may result in unnecessarily radical surgery. Local surgical resection is the treatment of choice for this lesion.
错构瘤是肿瘤样畸形,由原本正常的局部组织成分过度增殖引起。鼻腔和鼻窦错构瘤相对罕见,尤其是呼吸上皮腺样错构瘤。这种良性病变的特征是起源于呼吸上皮表面的腺体增生。在德语文献中,此前尚未描述过这种实体。
我们报告了一例51岁白人女性,患有左鼻腔呼吸上皮腺样错构瘤。患者有鼻塞症状。CT扫描显示一个软组织样病变阻塞了患者的左后鼻孔。通过功能性鼻内镜鼻窦手术,从鼻甲上端切除肿瘤后,患者症状消失。六个月后的随访未发现复发迹象。
呼吸上皮腺样错构瘤的组织病理学鉴别诊断包括内翻性乳头状瘤和腺癌。因此,对这些错构瘤的组织学识别会影响治疗。误诊为真正的肿瘤可能导致不必要的根治性手术。局部手术切除是该病变的首选治疗方法。