Publication:

Clinicopathologic and radiologic features of pediatric unilateral nasal masses at a tertiary hospital

Background Cases of unilateral nasal masses (UNM’s) are usually inflammatory but some are neoplastic in nature.  We conducted this study to determine the clinic-pathologic features, radiological findings and patterns of UNM’s in our institution.

Methods We conducted a retroactive chart review of all pediatric cases followed and treated for medically untreatable UNM from 2015 till 2018 at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia.

Results Cases of 25 patients (16 males and 9 females) with a mean age of 10.81±4.53 years were studied. There were 12 patients (48.0%) who presented with a nasal obstruction, and nasal polyp was found by fiberoptic nasal endoscopy (FNE) in 12 patients (48.0%). Two patients (8.0%) had unremarkable FNE findings. The most common site of origin of the mass was the ethmoid sinus (24.0%). Twenty patients (80.0%) had FESS, 3 (12.0%) had endoscopic excision, 1 had FESS plus abscess drainage and 1 (4.0%) had marsupialization. Two patients (8.0%) had recurrence 12 months after surgery, and one patient (4.0%) had recurrence six months after surgery. Six patients (24.0%) had malignant tumor of which 3 patients (12.0%) expired from the disease.

Conclusions Pediatric patients with a UNM may present with varied symptoms and may show unremarkable results with nasal endoscopy. However the risk of having an underlying malignant process is very high, thus a histopathologic diagnosis is warranted to confirm the diagnosis.