Angiectatic Polyp-An Unusual Nasal Mass in a Young Adult

Abstract

Angiectatic nasal polyps (ANP) are rare pseudo-neoplastic lesions that might raise intriguing pathophysiological issues and present a significant diagnostic challenge. They are also referred to as inflammatory granuloma telangiectaticum, vascular granuloma, pseudo-angioma, and angiomatous/angiectatic polyp. However, the name angiectatic polyp refers to the fact that the lesion is not a true tumour and is clinically distinguished by ectatic vasculature, haemorrhage, and persistent proliferation. The most confusing aspect of this polyp is its clinical appearance, which resembles a juvenile nasal angiofibroma. Despite its typical imaging characteristics, this lesion is difficult to differentiate radiologically. Hence, histopathology is paramount for establishing diagnosis. We report a rare case of a young adult who presented with complaints of nasal block and epistaxis. Examination revealed a vascular nasal mass and CT scan demonstrated the lesion to be epicentred in right nasal cavity extending to multiple sinuses with adjacent bone erosion. Patient underwent endoscopic excision of the mass with JNA as the predominant differential and only following histopathological examination, the final diagnosis was confirmed.

Keywords: Angiectatic nasal polyp; Angiomatous polyp; Juvenile nasal angiofibroma; Pseudo-angioma.

Fig. 1

Diagnostic nasal endoscopic image of the mass. Black arrow representing the intranasal mass

Fig. 2

Left nasal cavity (normal side)

Fig. 3

Coronal sections of the computed tomography showing a well-defined soft tissue density lesion epicentered in the right nasal cavity that extended into the right maxillary, ethmoid, frontal, and hemisphenoid sinuses, causing erosion of adjacent bones

Fig. 4

Axial sections of the computed tomography showing a well-defined soft tissue density lesion