Jamarun Stacy A, Wong Eugene Hung Chih
Department of Otorhinolaryngology, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Ministry of Health, Malaysia.
Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
Int J Surg Case Rep. 2022 May;94:107056. doi: 10.1016/j.ijscr.2022.107056. Epub 2022 Apr 7.
Primary nasopharyngeal amyloidosis is a rare entity of localised amyloidosis. Patients usually present with symptoms that mimic other common nasal diseases. We report an unusual case of nasopharyngeal amyloidosis that co-exist with nasal polyposis at the same time.
We described a 72-year-old gentleman who presented with left-sided nasal obstruction, rhinorrhoea and hyposmia and right-sided hearing loss. Examination revealed bilateral intranasal polyposis with right lobular swelling at torus tubarius and right sided middle ear effusion. Biopsy revealed inflammatory nasal polyps with nasopharyngeal amyloidosis. Patient was treated successfully with functional endoscopic sinus surgery (FESS) for nasal polyposis and an en bloc wide local excision of the torus tubarius with no signs of recurrence at one year follow-up.
Clinicians should have raised index of suspicion of a possible primary nasopharyngeal amyloidosis in patients presenting with nasopharyngeal mass with co-existing nasal polyposis to avoid delay in diagnosis and treatment.
原发性鼻咽淀粉样变性是局限性淀粉样变性的一种罕见类型。患者通常表现出与其他常见鼻部疾病相似的症状。我们报告一例同时合并鼻息肉病的不寻常鼻咽淀粉样变性病例。
我们描述了一位72岁男性,表现为左侧鼻塞、流涕和嗅觉减退以及右侧听力丧失。检查发现双侧鼻内息肉病,咽鼓管圆枕右侧有小叶状肿胀及右侧中耳积液。活检显示炎性鼻息肉合并鼻咽淀粉样变性。患者接受了功能性鼻内镜鼻窦手术(FESS)治疗鼻息肉病,并对咽鼓管圆枕进行了整块广泛局部切除,随访一年无复发迹象。
对于出现鼻咽肿物且合并鼻息肉病的患者,临床医生应提高对可能存在原发性鼻咽淀粉样变性的怀疑指数,以避免诊断和治疗延误。