The importance of the differential diagnosis in rhinology: respiratory epithelial adenomatoid hamartoma of the sinonasal tract.

INTRODUCTION Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon lesion of the nasal and paranasal sinuses. It was first described in 1995 by Wenig and Heffner, and only about 60 cases have been published since then. MATERIAL AND METHODS We present 6 case studies of nasal cavity hamartoma diagnosed and treated at our institution between 2005 and 2010. We also conducted a literature review and comprehensive study of the differential diagnosis of this condition, both clinical and pathological. RESULTS The male-female ratio was 5:1, with a mean age of 63.1 years. The most frequent symptoms were nasal obstruction, rhinorrhea and loss of smell. All cases were treated with endoscopic sinus surgery, without recurrences in the follow-up period (28.2 months; SD=11.5 months). CONCLUSION We suggest that differential diagnosis should be made on the basis of nasal polyps, antrochoanal polyps, inverted papilloma and low-grade adenocarcinoma. This review of published cases is of equal interest to both pathologists and otorhinolaryngologists.