The clinicpathological and radiological features of unilateral nasal mass in adults: A tertiary hospital experience

  • Dr. Atiur Rahman Assistant professor, Department of ENT, Shaheed Monsur Ali Medical College and Hospital, Uttara, Dhaka, Bangladesh
  • Dr. Md. Sazzadul-haq Assistant professor, Department of ENT, Munno Medical College and Hospital, Manikganj, Bangladesh
  • Dr. Md. Raqibul Alam Assistant professor, Department of ENT, Sheikh Hasina Medical College and Hospital, Tangail, Bangladesh.
Keywords: Clinicopathological, Unilateral nasal mass, Neoplastic pathology

Abstract

Introduction: Unilateral persistent nasal obstruction may indicate the presence of a sinonasal lesion, which could be inflammatory or neoplastic. It is a common practice to assume that unilateral nasal mass in adults is either inverted papilloma or a malignant lesion.

Aim of the study: Aim and objectives of the study were to analyze and study the diverse presentations of unilateral nasal mass and to identify the suggestive features of neoplastic pathology in adult population.

Methods: A retrospective analysis of 90 patients presented with unilateral sinonasal mass, reported to the Rhinology and Skull Base Clinic at the department of ENT in Shaheed Monsur Ali Medical College and Hospital, Uttara, Dhaka, Bangladesh. The cases reported from January 2019 till December 2019 were analyzed.

Result: A total of 34 patients reported to the rhinology clinic with unilateral sinonasal polyps consist of 21 (61.76%) males and 13 (38.24%) females with mean±SD age of 45.1±16.9, ranging from 19 to 78 years, of the 12 (35.29%) were smokers. The disease conditions were classified into different types (Figure 2) followed by benign tumors 18 (52.94%), 9 (26.47%) malignant cases, non-inflammatory 6 (17.65%), and mixed type 1 (2.94%). It is observed that there is a statistically significant relationship between gender (p=0.023) and the different types of diseases diagnosed.

Conclusion: Carcinoma, inflammatory polyposis, inverted papilloma, and allergic fungal sinusitis were the highest histological diagnosis. The clinical diagnosis and the suggestive features of radiological findings mostly resembled the histological findings. In contrary to the resemblance, the histological finding reveals the general diagnosis of nasal mass to the precise diagnosis, especially the fatal conditions like carcinoma. The high rate of malignancy and its suggestive radiological findings indicates that the specialists should consider the cases with caution to carry out histological analysis to rule out the probability of neoplasm.

Downloads

Download data is not yet available.

References

Hedman J, Kaprio J, Poussa T, Nieminen MM. Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. International journal of epidemiology. 1999 Aug 1;28(4):717-22.

Kirtsreesakul V. Update on nasal polyps: etiopathogenesis. Journal-Medical Association of Thailand. 2005 Dec 1;88(12):1966.

Varshney H, Varshney J, Biswas S, Ghosh SK. Importance of CT scan of paranasal sinuses in the evaluation of the anatomical findings in patients suffering from sinonasal polyposis. Indian Journal of Otolaryngology and Head & Neck Surgery. 2016 Jun;68(2):167-72.

Drake-Lee AB, Lowe D, Swanston A, Grace A. Clinical profile and recurrence of nasal polyps. The Journal of Laryngology & Otology. 1984 Aug;98(8):783-93.

Drake-Lee AB. Nasal polyps. Hospital Medicine. 2004 May;65(5):264-7.

Irfan M, Shamim AK. Routine histological examination for nasal polyp specimens: is it necessary? The Medical journal of Malaysia. 2009 Mar 1;64(1):59-60.

Safadi A, Carmel-Neiderman NN, Toledano R, Ungar OJ, Mokh FA, Wengier A, Fliss DM, Yafit D. The efficiency of routine histopathological examination for bilateral nasal polyposis. Ear, Nose & Throat Journal. 2021 Sep;100(5_suppl):670S-4S.

Karthikeya P, Mahima VG, Bhavna G. Sinonasal verrucous carcinoma with oral invasion. Indian Journal of Dental Research. 2006 Apr 1;17(2):82.

Kristensen S, Vorre P, Elbrond O, Søgaard H. Nasal Schneiderian papillomas: a study of 83 cases. Clinical Otolaryngology & Allied Sciences. 1985 Jun;10(3):125-34.

Uysal IÖ, Msr M, Polat K, Altuntas EE, Atalar MH, Tuncer E, Müderris S. Primary malignant melanoma of the nasal cavity. Journal of Craniofacial Surgery. 2012 Jan 1;23(1): e2-5.

Hulse KE, Stevens WW, Tan BK, Schleimer RP. Pathogenesis of nasal polyposis. Clinical & Experimental Allergy. 2015 Feb;45(2):328-46.

Kim WA. Tumours of the nose and sinuses. In: Hussain SM, editor. Logan turner's Diseases of the Nose, Throat and Ear Head and Neck Surgery. 11th ed. New York: CRC Press; 2016. pp. 119–29.

Paz Silva M, Pinto JM, Corey JP, Mhoon EE, Baroody FM, Naclerio RM. Diagnostic algorithm for unilateral sinus disease: a 15‐year retrospective review. InInternational forum of allergy & rhinology 2015 Jul (Vol. 5, No. 7, pp. 590-596).

Sutar HB. Clinicopathological study of nasal polypoidal masses. Ann Int Med Den Res. 2015; 1:315–9.

Kerawala C, Clarke P, Newbold K. Nasal cavity and paranasal sinus malignancy. In: Watkinson WC, Clarke RW, editors. Scott-Brown's Otorhinolaryngology Head and Neck Surgery. 8th ed. New York: CRC Press; 2009. pp. 73–91.

Klossek JM, Neukirch F, Pribil C, Jankowski R, Serrano E, Chanal I, El Hasnaoui A. Prevalence of nasal polyposis in France: a cross‐sectional, case–control study. Allergy. 2005 Feb;60(2):233-7.

Jessen M, Malrn L. Definition, prevalence and development of nasal obstruction. Allergy. 1997 Dec; 52:3-6.

Olszowiec-Chlebna M, Trzciński K, Stelmach I. Massive nasal polyposis in a patient with newly diagnosed cystic fibrosis. Advances in respiratory medicine. 2017;85(2):121-3.

Sahin B, Sönmez S, Kara H, Aydemir L, Çomoglu S. A rarely seen mass of nasal cavity: seromucinous hamartoma. Journal of Craniofacial Surgery. 2020 Jan 1;31(1): e65-7.

García M, CG PH. Nasal polyposis masquerading epidermoid carcinoma of the maxillary sinus. Importance of the biopsy in FENS. InAnales Otorrinolaringologicos Ibero-americanos 2005 Jan 1 (Vol. 32, No. 2, pp. 187-192).

Maina IW, Tong CC, Baranov E, Patel NN, Triantafillou V, Kuan EC, Kohanski MA, Papagiannopoulos P, Yan CH, Workman AD, Lambert JL. Clinical implications of carcinoma in situ in sinonasal inverted papilloma. Otolaryngology-Head and Neck Surgery. 2019 Dec;161(6):1036-42.

Akbay E, Özgür T, Çokkeser Y. Is there any relationship between the clinical, radiological, and histopathologic findings in sinonasal polyposis? Turk Patoloji Derg. 2013;29(2):127-33.

CITATION
DOI: 10.26838/MEDRECH.2022.9.1.575
Published: 2022-01-11
How to Cite
1.
Rahman A, Md. Sazzadul-haq, Md. Raqibul Alam. The clinicpathological and radiological features of unilateral nasal mass in adults: A tertiary hospital experience. Med. res. chronicles [Internet]. 2022Jan.11 [cited 2022May22];9(1):20-9. Available from: https://medrech.com/index.php/medrech/article/view/551
Section
Original Research Article