doiSerbia

Giant destructive sinonasal polyposis

Dimitrijević Milovan V. (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade)
Arsović Nenad A. (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade)
Dudvarski Zoran R. (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade)
Boričić Ivan V. (School of Medicine, Belgrade + School of Medicine, Institute of Pathology, Belgrade)

Introduction. Authors report their clinical experience in managing a 46-year-old male patient with long lasting nose breathing difficulties caused by nasal obstruction due to a large bilateral tumor masses in both nasal cavities. Case Outline. Physical examination, laboratory and biochemistry analyses, as well as computed tomography showed an inhomogeneous soft-tissue tumor mass completely filling both nasal cavities, maxillary, ethmoidal, sphenoidal, and frontal sinuses on both sides, accompanied by destruction of bony walls of all sinuses. Preoperative histopathology analysis showed a polyp with squamous metaplasia. The gigantic polypoid mass was removed by bicoronal approach to the frontal and ethmoidal sinuses and by direct approach to the maxillary sinuses and nasal cavity. Definite histopathology analysis confirmed the initial diagnosis, but the presence of fungal hyphae in allergic mucus was also observed. Conclusion. Polypoid growth in the nose rarely grow to such gigantic dimensions that it causes destruction of all walls of paranasal sinuses. Considering so far published reports from the literature, the presented case is among the biggest nasal polyps reported until now.

Keywords: giant sinonasal polyp, squamous metaplasia, surgical treatment

Projekat Ministarstva nauke Republike Srbije, br. 179055: Cochlear Implantation Impact of Education of Deaf and Hearing Impaired