Lateral Nasal Wall Respiratory Epithelial Adenomatoid Hamartoma (REAH): A Diagnostic Conundrum

• Main Authors: Liang-Chye Goh, Ming-Hui Wan, Gopalan Shashi, Krishnan Elangkumaran
• Format: Article
• Language: English
• Published: Mashhad University of Medical Sciences 2018-07-01
• Series: Iranian Journal of Otorhinolaryngology
• Subjects: Electrocautery; Endoscope; Hamartoma; Nasal cavity
• Online Access: http://ijorl.mums.ac.ir/article_11143_26c1b892a0c95c1c2338517dbd16809b.pdf

Introduction: This study aims to report a rare case of a respiratory epithelial adenomatoid hamartoma (REAH) of the lateral nasal wall that had initially presented as a fungating mass, similar to that of a sinonasal malignancy, and its complete removal from the lateral nasal wall.   Case Report: We report the case of a 58-year-old woman who presented to us with a chief complaint of recurrent right-sided epistaxis and nasal blockage for the past 4 months, which was progressively worsening. Histopathological examination confirmed the presence of a REAH instead of a sinonasal malignancy. The tumor was surgically excised from the lateral nasal wall using electrocautery under endoscopic guidance. The patient was then carefully followed-up after surgery, and the wound was successfully healed 3 months after the initial surgery. There was no evidence of recurrence 6 months after the initial surgery   Conclusion: This case demonstrates the rare presentation of a REAH, which had arisen from the lateral nasal wall. Clinically, it is difficult to distinguish a REAH from a more notorious mass such as a sinonasal malignancy. Therefore, biopsy is mandatory in all cases of lateral nasal mass in order to rule out malignancy before confirming nasal REAH. Fortunately, as seen in this case, a lateral nasal REAH, once diagnosed, can be safely and easily removed from the lateral nasal wall using electrocautery with good surgical outcomes and a low rate of recurrence.