title: Bilateral respiratory epithelial adenomatoid hamartoma of the olfactory cleft penetrating into the endocranium.
abstract: Respiratory epithelial adenomatoid hamartomas (REAHs) of the nose and paranasal sinuses are relatively rare. These tumors usually do not extend over the boundaries of the nose and sinuses. The authors presented a 65-year-old man experiencing progressive hyposmia, followed by intermittent stubborn headache. The symptoms lasted for almost 2 years and were getting worse very slowly. Fiberendoscopy showed relatively discrete polypoid tissue occupying the olfactory cleft bilaterally. The computed tomography and magnetic resonance imaging suggested the possible lack of the cribriform plate and the unity and uniformity of the tissues located both in the endocranium and high in the nasal cavity. The clinical picture resembled very much a esthesineuroblastoma.The patient underwent endoscopic sinus surgery under the general hypotensive anesthesia. Frozen sections during the surgery showed REAH. The entire tumor was removed in a piece meal way, including both olfactory bulbs because they were involved within the pathologic tissue as well.This case showed that REAH could also be a locally aggressive process, penetrating even into the endocranium.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University Hospital Rebro, Zagreb, Croatia.
authors.forename: Ranko
authors.initials: R
authors.lastname: Mladina
authors.forename: Neven
authors.initials: N
authors.lastname: Skitarelić
authors.forename: Gorazd
authors.initials: G
authors.lastname: Poje
authors.forename: Katarina
authors.initials: K
authors.lastname: Vuković
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000601:surgery*; D000368:Aged; D003937:Diagnosis, Differential; D004724:Endoscopy; D006222:Hamartoma / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009668:Nose Diseases / Q000175:diagnosis* / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures; D019291:Skull Base / Q000601:surgery; D014057:Tomography, X-Ray Computed