Unilateral Sinonasal Masses: Review of Clinical Presentation and Outcome in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Sinonasal Inflammation or Neoplasm: Raise the Red Flagsǃ-A Pictorial Review

Inflammatory pathology remains the most common indication for sinonasal imaging. However, sinonasal region is also the epicenter of a variety of neoplasms. These are often missed both clinically and radiologically owing to nonspecific signs and symptoms and subtle imaging pointers. An early diagnosis of sinonasal neoplasms is critical for timely management and hence better prognosis and survival rate. This pictorial review aims to acquaint the reader with the "red flag" signs on computed tomography that should raise suspicion for an underlying neoplastic pathology and also highlights the imaging features of common sinonasal neoplasms.

The incidence of significant pathology in patients presenting with benign-appearing unilateral nasal polyps

Objective

The presentation of unilateral nasal polyps traditionally necessitates histological evaluation for a neoplasm. This study sought to determine the rates of significant pathology in patients presenting with benign-appearing unilateral nasal polyps, to inform practice.

Method

All patients who underwent nasal polypectomy for benign-appearing unilateral nasal polyps over a 13-year period were included.

Results

A total of 77 patients were included. On histology, 60 cases (77.9 per cent) were found to be inflammatory polyps. Thirteen cases were neoplastic, of which 11 (14.3 per cent) were benign and 2 (2.6 per cent) were malignant neoplasms. The following significant pathologies were found: Schneiderian papillomas, in 10 cases (13.0 per cent); neurofibroma, in 1 case (1.3 per cent); adenoid cystic carcinoma, in 1 case (1.3 per cent); and malignant melanoma, in 1 case (1.3 per cent).

Conclusion

Our data support routine histological assessment for all unilateral nasal polyps. Malignancy is rare (2.6 per cent) in patients presenting with benign-appearing unilateral nasal polyps. In elderly, unfit patients with minimal symptoms, initial conservative management may be reasonable.

Analysis of Disease Patterns in Patients with Unilateral Sinonasal Diseases: A Tertiary Care Hospital Experience

AIMS

The aim of the present study was to evaluate the clinicopathological profile of sinonasal masses and to identify features suggestive of neoplastic pathology.

MATERIALS AND METHODS

A retrospective review of all sinonasal masses in patients attending a tertiary care hospital between April 2019 to Feb 2020 presenting at a tertiary care hospital were analysed. The demographic data, presenting symptoms, radiological and histopathological diagnosis were analysed.

RESULTS

In the present study total 23 patients with age ranging from 8 to 72 years were analysed. The overall M:F ratio was 1.55:1. Most of the patients (56%) belong to 31-60 year age group. The main presenting symptoms were nasal obstruction and rhinorrhoea. Epistaxis and extranasal symptoms like facial pain, dental and orbital complaints were found to be higher in neoplastic conditions. The number of non-neoplastic lesions were more than neoplastic with 78.2% being reported to be antrochoanal polyp and ethmoidal polyps, 8.69% being inverted papillomas and 13% cases were histopathologically reported to be malignant. Neoplastic conditions were significantly commoner in males and in the age group 40-60 years.

CONCLUSION

We concluded that clinical, radiologic, and histopathological evaluation is essential for proper diagnosis and stress the importance of immunohistochemistry which is the ultimate diagnostic technique in certain neoplastic lesions.