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Avsenik J, Albalkhi I, Prabhu SP, Radhakrishnan R, Goetti R, Jaju A, Merve A, Biswas A, Mankad K. Pediatric nasal chondromesenchymal hamartomas: a case series. Neuroradiology 2024; 66:437-441. [PMID: 38206352 DOI: 10.1007/s00234-023-03276-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE Nasal chondromesenchymal hamartomas (NCMH) are rare, predominantly benign tumors of the sinonasal tract. The distinction from higher grade malignancy may be challenging based on imaging features alone. To increase the awareness of this entity among radiologists, we present a multi-institutional case series of pediatric NCMH patients showing the varied imaging presentation. METHODS Descriptive assessment of imaging appearances of the lesions on computed tomography (CT) and magnetic resonance imaging (MRI) was performed. In addition, we reviewed demographic information, clinical data, results of genetic testing, management, and follow-up data. RESULTS Our case series consisted of 10 patients, with a median age of 0.5 months. Intraorbital and intracranial extensions were both observed in two cases. Common CT findings included bony remodeling, calcifications, and bony erosions. MRI showed heterogeneous expansile lesion with predominantly hyperintense T2 signal and heterogenous post-contrast enhancement in the majority of cases. Most lesions exhibited increased diffusivity on diffusion weighted imaging and showed signal drop-out on susceptibility weighted images in the areas of calcifications. Genetic testing was conducted in 4 patients, revealing the presence of DICER1 pathogenic variant in three cases. Surgery was performed in all cases, with one recurrence in two cases and two recurrences in one case on follow-up. CONCLUSION NCMHs are predominantly benign tumors of the sinonasal tract, typically associated with DICER1 pathogenic variants and most commonly affecting pediatric population. They may mimic aggressive behavior on imaging; therefore, awareness of this pathology is important. MRI and CT have complementary roles in the diagnosis of this entity.
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Affiliation(s)
- Jernej Avsenik
- Clinical Institute of Radiology, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000, Ljubljana, Slovenia.
- Department of Radiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | | | - Sanjay P Prabhu
- Division of Neuroradiology, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rupa Radhakrishnan
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert Goetti
- Department of Medical Imaging, The Children's Hospital at Westmead, New South Wales, Australia
| | - Alok Jaju
- Department of Medical Imaging, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Ashirwad Merve
- Neuropathology Department, Great Ormond Street Hospital, London, UK
| | - Asthik Biswas
- Department of Neuroradiology, Great Ormond Street Hospital, London, UK
| | - Kshitij Mankad
- Department of Neuroradiology, Great Ormond Street Hospital, London, UK
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Javadirad E, Azimivaghar J, Montazer S, Sharafi S. A Systematic Review of Nasal Chondromesenchymal Hamartoma (NCMH) with a New Case Report. Head Neck Pathol 2022; 16:1172-1184. [PMID: 35507301 PMCID: PMC9729677 DOI: 10.1007/s12105-022-01452-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/24/2022] [Indexed: 12/16/2022]
Abstract
Nasal chondromesenchymal hamartoma (NCMH) is a very rare, benign sinonasal tract tumor commonly affecting infants. In this paper, in addition to presenting a systematic review of the literature on NCMH, we also report an unusual case of NCMH in an adolescent patient. A systematic review conducted following the PRISMA guidelines. PubMed, EMBASE and manual search through references of relevant publication were utilised to gather all published case-reports of NCMH. Data collected from each case-report for patient demographics, site and size of NCMH, clinical presentation, co-morbidities, diagnostic methods, treatment options and follow-up methods. The systemic review collected sixty-two case-reports of NCMH (including our case) affecting 42 men and 21 women (2:1 male to female ratio). Mean average age was 5.1 years (age range: 1 day to 70 years). The anatomical sites of the tumor were: nasal cavity (n = 17), paranasal sinuses (n = 30), orbital region (n = 17), and the base of the skull (n = 16). The reported clinical manifestations were nasal obstruction or congestion (n = 29), nasal mass (n = 27), epistaxis (n = 6), orbital symptoms (n = 14). NCMH is a very rare cause of nasal masses in infants and toddlers. Our case and previous case reports confirm that NCMH can mimic other benign and malignant tumors, therefore we should be vigilant for rare pathologies that lead to nasal masses. Recently the link between DIECR1 mutation with NCMH has been established, so NCMH should be considered in any patient with nasal or orbital symptoms with a history of DICER1-related tumor spectrum.
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Affiliation(s)
- Etrat Javadirad
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Javad Azimivaghar
- Department of Cardiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saba Montazer
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soraya Sharafi
- Clinical Dermatology, Leatherhead Hospital, Leatherhead, UK
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3
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Zhu ZJ, Huang Q, Cheng L, Yang J. Transnasal endoscopic resection of nasal chondromesenchymal hamartoma in infancy: an analysis of 5 cases. BMC Pediatr 2022; 22:24. [PMID: 34991521 PMCID: PMC8734269 DOI: 10.1186/s12887-021-03082-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 12/17/2021] [Indexed: 11/12/2022] Open
Abstract
Background Nasal chondromesenchymal hamartomas (NCMHs) are extremely rare benign tumors that most commonly affect children in the first year of life. The purpose of this study was to investigate and summarize the characteristics of NCMH cases and the efficacy of transnasal endoscopic resection of NCMHs. Methods This is a retrospective study including 5 cases of infant diagnosed as NCMH between April 2016 and April 2020. Diagnostic techniques include nasoendoscopy, computerized tomography (CT) scan, magnetic resonance imaging (MRI) with contrast and microscopic and immunohistologic studies. Data collected included patient demographics, patient symptoms, radiographic findings, characteristics of tumor growth, follow-up time, recurrence, and postoperative complications. Results In 5 cases, 3 were males and 2 were females who aged 1, 2, 3, 6 months and 1 year, respectively. The size of the mass measured 1.6 cm*1.9 cm*1.8 cm at its smallest and largest was 4.0 cm*3.5 cm*3.0 cm. All five patients underwent tumor resection via transnasal endoscopic approach. Four tumors were completely removed, and one underwent partial resection, which was completely resected by midfacial degloving operation 13 months after the first surgery. There was no postoperative complication. The current postoperative follow-up period was 1 to 4 years, and no recurrence has been observed. Conclusions Complete surgical resection of NCHM is necessary to resolve the symptoms and prevent recurrence. Transnasal endoscopic approach is a safe and effective choice for pediatric NCMH patients.
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Affiliation(s)
- Zheng Jie Zhu
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Qi Huang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Lan Cheng
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Jun Yang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 1665 Kongjiang Road, Shanghai, 200092, China.
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A Rare Cause of Respiratory Distress in Newborn: Huge Nasal Chondromesenchymal Hamartoma; Patient Report. J Craniofac Surg 2021; 33:e411-e413. [PMID: 34690308 DOI: 10.1097/scs.0000000000008309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Nasal chondromesenchymal hamartoma is a rare benign tumor of the sinonasal tract in pediatrics and only few cases in infantile, early pediatric, and adolescent population have been reported. Nasal chondromesenchymal hamartoma commonly presents as respiratory difficulty, intranasal mass, or facial swelling and typically arises from the nasal septum or vestibule, lest frequently maxillary or ethmoid sinuses, orbit, nasopharynx, and oropharynx. The authors report a case of nasal chondromesenchymal hamartoma that caused respiratory distress since birth, in a 4-week-old (28 days) infant which was arised from the medial aspect of the middle turbinate, an unexpected localization.
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Nasal chondromesenchymal hamartoma: an update. The Journal of Laryngology & Otology 2021; 136:1140-1147. [PMID: 34420530 DOI: 10.1017/s0022215121002267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Millarelli S, Mammarella F, Loperfido A, Stella F, Bellocchi G. The first case of nasal chondromesenchymal hamartoma in an octogenarian: description and literature review. JOURNAL OF GERONTOLOGY AND GERIATRICS 2021. [DOI: 10.36150/2499-6564-n362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ozolek JA, Tekkesin MS. THE "-OMAS" and "-OPIAS": Targeted and Philosophical Considerations Regarding Hamartomas, Choristomas, Teratomas, Ectopias, and Heterotopias in Pediatric Otorhinolaryngologic Pathology. Head Neck Pathol 2021; 15:25-40. [PMID: 33723758 PMCID: PMC8010027 DOI: 10.1007/s12105-020-01251-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Abstract
The spectrum of "developmental" lesions that occur in the head and neck predominantly congenital in origin and arising at birth and/or discovered in childhood is broad and fascinating. These have been grouped into categories such as "ectopias", "heterotopias", "hamartomas", and "choristomas". On a philosophical and consequently systematic level, these lesions, mostly benign tumors seem to lack a true understanding of the pathogenetic foundation on which to base a more unified taxonomic designation. In this review, we will consider some of these select tumors as they represent syndromic associations (nasal chondromesenchymal hamartoma and DICER1 syndrome), the lingual choristoma from the perspective of its nomenclature and classification, lesions with ectopic meningothelial elements, and teratomas and the enigmatic "hairy polyp" in reference to a broader discussion of pathogenesis and pluripotent cells in the head and neck. A consistent thread will be how these lesions are designated with some final thoughts on future directions regarding the investigation of their pathogenesis and taxonomic nomenclature.
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Affiliation(s)
- John A Ozolek
- Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University School of Medicine, Morgantown, WV, USA.
| | - Merva Soluk Tekkesin
- Department of Tumour Pathology, Institute of Oncology, Istanbul University, Istanbul, Capa-Istanbul, 34093, Turkey
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Nasal Chondromesenchymal Hamartoma: A Rare Benign Lesion in Adult Female. Indian J Otolaryngol Head Neck Surg 2021; 74:1253-1255. [PMID: 33437683 PMCID: PMC7790346 DOI: 10.1007/s12070-020-02333-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/14/2020] [Indexed: 12/02/2022] Open
Abstract
Nasal chondromesenchymal hamartoma (NCMH) is a rare benign lesion of the sinonasal tract in children and adolescent with orbital involvement.
NCMH is histologically composed of nodules of cartilage with cellular density variation and maturation of the chondrocytes, a myxoid to spindle cell stroma, focal osteoclast-like giant cells in the stroma, and erythrocyte-filled spaces. This lesion may present with a destructive pattern on imaging, highly suggestive of malignancy. Total endoscopic resection is the choice of treatment nowadays, however incomplete excision could result in tumor recurrence but rare.
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Schaerer D, Nation J, Rennert RC, DeConde A, Levy ML. Pediatric Nasal Chondromesenchymal Tumors: Case Report and Review of the Literature. Pediatr Neurosurg 2021; 56:61-66. [PMID: 33571989 PMCID: PMC7969402 DOI: 10.1159/000512717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/16/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Nasal chondromesenchymal tumors (NCMT) are rare benign neoplasms that usually present in children <1 year of age. They can display rapid growth and significant local bony remodeling that can mimic a malignant process. Of the ∼50 published cases to date, few have documented the need for neurosurgical intervention. We herein report a NCMT in an infant treated with a staged cranial and transnasal approach, as well as summarize the available literature on this pathology. CASE REPORT A newborn male with a compromised airway was noted to have a large sinonasal lesion. After stabilization, MRI demonstrated a 4-cm enhancing mass with diffuse sinus involvement and significant extension into the anterior cranial fossa, with displacement of the optic apparatus and hypothalamic pituitary axis. After an initial biopsy, the patient underwent a bifrontal craniofacial approach at 2 months of age, followed by a second-stage transnasal endoscopic approach at 15 months which resulted in a complete resection. There were no neurosurgical complications. Pathology was consistent with a NCMT. DISCUSSION Although rare, neurosurgical involvement is critical for the treatment of NCMTs with intracranial extension. Staged cranial and endonasal endoscopic approaches may be needed for complete resection of such lesions.
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Affiliation(s)
- Daniel Schaerer
- Department of Head and Neck Surgery, University California San Diego, San Diego, California, USA
| | - Javan Nation
- Department of Head and Neck Surgery, University California San Diego, San Diego, California, USA
| | - Robert C Rennert
- Department of Neurosurgery, University California San Diego, San Diego, California, USA
| | - Adam DeConde
- Department of Head and Neck Surgery, University California San Diego, San Diego, California, USA
| | - Michael L Levy
- Department of Neurosurgery, University California San Diego, San Diego, California, USA, .,Rady Children's Hospital of San Diego, San Diego, California, USA,
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Cui YQ, Wang LL, Huang G, Zhao LP. Computed tomography and magnetic resonance imaging findings of nasal chondromesenchymal hamartoma in a young child: a case report. J Int Med Res 2020; 48:300060520920431. [PMID: 32780662 PMCID: PMC7425268 DOI: 10.1177/0300060520920431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 03/18/2020] [Indexed: 11/16/2022] Open
Abstract
Nasal chondromesenchymal hamartoma (NCMH) is a rare destructive benign neoplasm that predominantly develops in infants and young children. The lesion is usually located in the nasal cavity, often in the adjacent paranasal sinuses and orbital region and especially in the ethmoid sinus. Because the imaging characteristics of NCMH often mimic the features of malignant tumors, it is clinically important to study the radiographic appearance of this disease. Therefore, we herein present the computed tomography and magnetic resonance imaging findings of NCMH occurring in a 7-year-old girl. The mass was resected via an endoscopic surgical approach and definitively diagnosed as NCMH based on histologic and immunohistochemical analysis. However, signs of tumor recurrence manifested 45 months after surgery. NCMH can be locally aggressive with an expansive and destructive radiographic appearance, which highly implies a malignant neoplasm. Hence, an accurate diagnosis is essential to avoid potentially harmful therapies, and detailed computed tomography or magnetic resonance imaging should be performed prior to surgery. Selective arterial embolization is also an important part of preoperative management because the degree of enhancement may not be adequate to determine the blood supply of the tumor. Moreover, complete radical excision cannot guarantee that the lesion will not recur.
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Affiliation(s)
- Ya-qiong Cui
- Gansu University of Chinese Medicine, Lanzhou, Gansu, China
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Li-li Wang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Gang Huang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Lian-ping Zhao
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu, China
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Vasta LM, Nichols A, Harney LA, Best AF, Carr AG, Harris AK, Miettinen M, Schultz KAP, Kim HJ, Stewart DR. Nasal chondromesenchymal hamartomas in a cohort with pathogenic germline variation in DICER1. RHINOLOGY ONLINE 2020; 3:15-24. [PMID: 34164613 DOI: 10.4193/rhinol/20.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background Nasal chondromesenchymal hamartomas are benign, rare nasal tumors associated with DICER1 pathogenic germline variation. They can be locally destructive and recurrent if not completely resected. Methodology In this single-center, case-control study, otorhinolaryngology evaluations and review of systems questionnaires of DICER1-carriers and controls enrolled in the DICER1 Natural History Study at the National Cancer Institute were collected. Review of these medical records were analyzed to determine if DICER1-carriers experienced different sinonasal clinical manifestations compared to controls. Additionally, the number of diagnoses of nasal chondromesenchymal hamartoma cases in the NCI DICER1 study was compared against the total person years of observation of DICER1-carriers in the study to determine the total number of cases per person-years of observation. Lastly, both the NCI DICER1 study and the International Pleuropulmonary Blastoma/DICER1 Registry were queried for unpublished cases of nasal chondromesenchymal hamartomas. Results There were no clinical differences in sinonasal symptomatology between DICER1-carriers and control patients seen in the ENT clinic. We observed of two cases of nasal chondromesenchymal hamartoma in a total of 555 person-years of monitoring DICER1-carriers. We include six unpublished nasal chondromesenchymal hamartoma cases. When combined with a comprehensive literature review, 38% of nasal chondromesenchymal hamartoma cases had at least one additional DICER1-associated tumor and 24% of the NCMH were found in the ethmoid sinus, the most commonly involved paranasal sinus. Conclusions We quantify the risk of developing nasal chondromesenchymal hamartomas in our cohort of 236 DICER1-carriers, report six unpublished cases, and provide an updated review of the literature.
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Affiliation(s)
- Lauren M Vasta
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.,National Capital Consortium, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Alison Nichols
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | | | - Ana F Best
- Biostatistics Branch, Biometric Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, NIH, Rockville, MD, USA
| | | | - Anne K Harris
- International Pleuropulmonary Blastoma/DICER1 Registry, Minneapolis, MN, USA
| | - Markku Miettinen
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Kris Ann P Schultz
- International Pleuropulmonary Blastoma/DICER1 Registry, Minneapolis, MN, USA.,Cancer and Blood Disorders Program, Children's Minnesota, Minneapolis, MN, USA
| | - Hung Jeffrey Kim
- Office of Clinical Director, National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, MD.,Department of Otolaryngology-HNS, Georgetown University Medical Center, Washington, DC, USA
| | - Douglas R Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
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Nasal Chondromesenchymal Hamartoma: Rare Case Report in an Elderly Patient and Brief Review of Literature. Case Rep Pathol 2018; 2018:5971786. [PMID: 30405930 PMCID: PMC6204234 DOI: 10.1155/2018/5971786] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/24/2018] [Indexed: 11/17/2022] Open
Abstract
Hamartomas are considered a mixture of nonneoplastic tissue, which may be indigenous to a different location in the body. As such, they may be epithelial, mesenchymal, or mixed. In the sinonasal region, the following hamartomatous lesions are considered to lie on a spectrum and include respiratory epithelial adenomatoid hamartoma (REAH), chondro-osseous respiratory epithelial adenomatoid hamartoma (COREAH), and nasal chondromesenchymal hamartoma (NCMH). To our knowledge, less than 50 cases of sinonasal hamartomas have been reported in the English literature so far with NCMH being very rare and primarily a tumor in infancy, with only 2 cases reported in individuals older than 16 years of age. We report a highly unusual case of a NCMH in the right maxillary sinus of a 70-year-old female.
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Golbin DA, Ektova AP, Demin MO, Lasunin N, Cherekaev VA. Nasal Chondromesenchymal Hamartoma with Skull Base and Orbital Involvement: Case Presentation. Cureus 2018; 10:e2892. [PMID: 30167348 PMCID: PMC6112910 DOI: 10.7759/cureus.2892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Nasal chondromesenchymal hamartoma (NCMH) is a rare benign tumor of the sinonasal tract in children with possible orbit and skull base involvement. We present the 57th published observation of this kind of tumor. A 25-month-old female patient presented with recurrent mass lesion of the sinonasal tract. According to her history, she had feeding difficulties and nasal obstruction since birth. She underwent partial resection at eight months of age via transfacial approach in the local hospital. Due to progression of tumor remnants, a second surgery was performed using an endoscopic endonasal approach resulting in subtotal resection. At 12 months of follow-up, a good postoperative result was observed with no signs of tumor progression despite incomplete resection. Histological and immunohistochemical examination of the biopsy specimens is presented. Comparison of specimens obtained from each of the two surgeries showed a difference in histological patterns. Endoscopic endonasal approach is the mainstay of surgical management. In case of incomplete resection, careful follow-up MRI studies should be recommended.
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Affiliation(s)
- Denis A Golbin
- Skull Base and Craniofacial Surgery, N.N. Burdenko National Medical Research Center for Neurosurgery, Moscow, RUS
| | | | | | - Nikolay Lasunin
- Neuro-Oncology, N.N. Burdenko National Medical Research Center for Neurosurgery, Moscow, RUS
| | - Vasily A Cherekaev
- Skull Base and Craniofacial Surgery, N.N. Burdenko National Medical Research Center for Neurosurgery, Moscow, RUS
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