Introduction: Due to its ability to erode bone and generate epistaxis, angiomatous antrochoanal nasal polyp (AAP) is a rare and distinct form of a sinonasal polyp that can be mistaken for a sinonasal malignancy, juvenile nasopharyngeal angiofibroma, or a simple antrochoanal polyp. It is responsible for around 5% of all nasal polyps.
Vascular growth and ectasia are common, along with the deposition of pseudoamyloid and the presence of atypical stromal cells. This pseudoneoplastic entity of these polyps is responsible for the significant reparative and reactive alterations. Because the lesion often manifests late, it can be difficult to diagnose and treat. AAP has a proclivity for bleeding and bone erosion. Such unusual situations are discussed here, along with a review of the literature on their characteristics and management.
Angiomatous antro choanal polyp (AAP) is an uncommon variation of sinochoanal polyp that we report in two cases. Recurrent unilateral epistaxis and nasal obstruction were reported in the cases. Bony wall degradation was discovered on a CT scan. The nasal cavity mass was a reddish pink tint. On the basis of the histology report, endoscopic sinus surgery was conducted and a final diagnosis of angiomatous antrochoanal polyp was made.
Management: The tumour was entirely resected using an endoscopic medial maxillectomy method, with an open lateral rhinotomy approach preserved as a backup in case the endoscopic route failed. An inflammatory polyp was identified in a preoperative biopsy, but the postoperative specimen was identified as an AAP.
Discussion and conclusion: Because there are few studies on this subject, there is minimal content in the textbook. Because ANP is such a rare pathological condition, it can be difficult to diagnose. Clinical, radiological, and pathological information are frequently complementary and provide a definitive diagnosis when combined. It is essential to be aware of the presence of such tumours at all times. Antrochoanal polyp, juvenile angiofibroma, malignancy, papilloma, and hemangioma are among the differential diagnoses.
Author(s) Details:
Lokesh K. Bhama,
Department of ENT, Dr Bhama ENT Clinic, Mumbai, Maharashtra, India.
Nirmal K. Soni,
Department of ENT, University Medical College, Jaipur, Rajasthan, India.
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