Bilateral Polypoid Degeneration of the Inferior Turbinates Mimicking Intranasal Neoplasia: A Case Report

双侧下鼻甲息肉样变性,酷似鼻内肿瘤:病例报告

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Abstract

Lesions of the inferior turbinate are exceedingly rare, with one retrospective series identifying only 34 cases over 14 years. Of those, approximately 68 % were benign (predominantly hemangiomas), and about 32 % were malignant (most commonly non-Hodgkin's lymphoma). Data on polypoid degeneration of the inferior turbinate are limited, particularly regarding histopathologic features and treatment outcomes. This case report aims to contribute to the existing literature by providing detailed clinical, radiologic, and histologic findings, as well as therapeutic considerations for this rare entity. We report the case of a 43-year-old man from Africa (Democratic Republic of the Congo) presenting with a three-month history of severe nasal obstruction, mouth breathing, and intermittent bilateral epistaxis. Physical examination revealed large, soft, pinkish polypoid masses obstructing both nasal cavities. Imaging studies showed bilateral paraseptal tumors without paranasal sinus involvement. Endoscopic exploration revealed that the tumors originated from the medial mucosal surfaces of the inferior turbinates. The masses were excised with monopolar cautery along with a small part of the normal mucosa of the rest of the inferior turbinates. Histopathological examination revealed polypoid degeneration of fibrous tissue with inflammatory infiltration, edema, seromucous glands, and congested blood vessels. Postoperatively, the patient received antibiotics, nasal irrigation, and nasal ointment. The patient reported substantial improvement in nasal breathing one month later. Nasal cavities were patent without crusting. Polypoid degeneration of the inferior turbinate, although very rare, should be included in the differential diagnosis of inferior turbinate pathology.

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