Abstract
IntroductionRespiratory Epithelial Adenomatoid Hamartoma (REAH) is a benign disease that can resemble other malignant entities. Thus, it is essential to diagnose it accurately as the treatment approach differs, from radical surgeries in malignant cases, to a simple excision in hamartoma. We present an unusual case of bilateral REAH that was misdiagnosed, and hence it was treated aggressively.Case reportA 57-year-old male patient presented with anosmia, 2-years history of bilateral nasal obstruction, and was accompanied with a moderate headache. An impression of olfactory neuroblastoma was made after history taking physical examination, and imaging studies. The patient underwent Functional Endoscopic Sinus Surgery (FESS), excisional biopsy of the cribriform plate mass bilaterally, and superior septectomy. Histopathologic examination of the bilateral masses showed sinonasal polyposis with crypting of surface mucosa and pseudoglandular formation. A diagnosis of sinonasal polyps with REAH was established. The patient's nasal obstruction improved, with no recurrence of sinusitis ± polyposis. However, he still complains of anosmia after 2-years follow-up.ConclusionAlthough REAH is a benign disease, it is critical to reach the correct diagnosis, in order to avoid aggressive treatment. Unfortunately, the preoperative investigations were not consistent with REAH, thus it was misdiagnosed and treated aggressively.
Highlights
Respiratory Epithelial Adenomatoid Hamartoma (REAH) is a benign disease that can resemble other malignant entities
They can arise anywhere in the body, they are more common in the lung, kidney, liver, spleen, and intestine [1].In 1995, Wenig and Heffner described a type of sinonasal tissue anomaly, and designated it as Respiratory Epithelial Adenomatoid Hamartoma (REAH) [4]
We present an unusual case of bilateral REAH, which was diagnosed as olfactory neuroblastoma over treated
Summary
Hamartomas are benign, non-neoplastic lesions that develop secondary to tissue-development anomalies, and are composed of overgrowth of normal and mature cells and tissues that are normally present in the affected location, but in a disorganized manner [1,2]. Hamartomas were first described by Albrect in 1904 [3] They can arise anywhere in the body, they are more common in the lung, kidney, liver, spleen, and intestine [1].In 1995, Wenig and Heffner described a type of sinonasal tissue anomaly, and designated it as Respiratory Epithelial Adenomatoid Hamartoma (REAH) [4]. We present an unusual case of bilateral REAH, which was diagnosed as olfactory neuroblastoma over treated. This case report has been reported in line with the SCARE criteria [6]
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