An unusual nasal polyp

xlomafota13 shared this article with you from Inoreader Message: https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S1879729621001393/first-page-pdf ,A 76-year-old patient was referred for isolated, permanent, complete left nasal obstruction, refractory to local treatments and gradually deteriorating over a period of ten years. Ophthalmological and neurological examination was normal. Nasal endoscopy (Fig. 1) demonstrated a pink, homogeneous, non-pulsatile, ∗ Corresponding author at: Hôpital d'Instruction des Armées Sainte-Anne, BCRM Toulon, 2, boulevard Sainte-Anne BP 600, Toulon cedex 9 83800, France. E-mail address: jbmorvan@hotmail.com (J.-B. Morvan). obstructive polypoid lesion medial to the left middle turbinate and extending inferiorly as far as the posterior aspect of the inferior turbinate. The lesion was soft and resilient on palpation. The middle meatus was not involved. Head CT scan showed a solid, polypoid lesion centred on the sella turcica (Fig. 2), measuring 60 mm by 43 mm by 37 mm with suprasellar extension between the frontal hemispheres and invading the cavernous sinuses laterally, the sphenoid sinuses and the posterior part of the left nasal cavity with osteolysis of the walls of the sella turcica. Intense and homogeneous contrast enhancement was observed. Magnetic resonance imaging (Fig. 3) visualised this homogeneous, champagne cork-shaped lesion penetrating through the diaphragma sellae with a discrete T2 hypersignal with no calcification, displacing withoutinvading the optic chiasm,the cavernous segment ofthe internal carotidarteries andthe frontallobes. 18F-FDG PET-CT (Fig. 4) showed isolated intense increased uptake with a SUVmax of 32.6. A hormonal work-up did not reveal hyperprolactinaemia or hypopituitarism. Transnasal endoscopic biopsy for histological examination was performed under general anaesthesia. Histological examination (Fig. 5) revealed a lesion with a sheetlike architecture, richly vascularized by fine capillaries, composed of monomorphic round cells, with scant, non-vacuolized cytoplasm, rare mitotic figures and no necrosis. Tumour cells expressed chromogranin and synaptophysin neuroendocrine markers, with low expression of LH. The Ki-67 proliferative index was estimated at 2%. An unusual nasal polyp Via oto-rhino-laryngologie Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Jun 24:S1879-7296(21)00139-3. doi: 10.1016/j.anorl.2021.06.005. Online ahead of print. NO ABSTRACT PMID:34176776 | DOI:10.1016/j.anorl.2021.06.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.