Nadir Bir Antite: Yaygın Tutulum Gösteren Sinonazal Onkositik Papillom

Yıl 2024, Cilt: 9 Sayı: 2, 313 - 317, 02.06.2024

Nuket Özkavruk Eliyatkın , Erdem Eren , Nezahat Erdoğan

https://doi.org/10.61399/ikcusbfd.1354567

Öz

Papillomlar, sinonazal traktın benign epitelyal tümörleridir. Sinonazal papillomlar başboyun tümörleri arasında nadir olarak görülür ve Schneiderian membranından köken alırlar. Papillomların, ekzofitik, inverted ve onkositik olarak üç farklı histopatolojik tipi vardır. Onkositik tip, en nadir görülen histopatolojik tiptir. Bu sunumda 69 yaşında erkek hastada yaygın tutulum gösteren onkositik tipte sinonazal papillom olgusu sunulmuştur. Altı yıl önce travma nedeniyle çekilen grafilerde sol nazal kavitede kitle saptanmıştır. Hasta tedaviyi kabul etmediği için kitle zamanla büyük boyutlara ulaşmış ve belirgin obstrüksiyona neden olmuştur. Kitlenin yaygın tutulumu nedeniyle geniş kitle eksizyonu yapılmıştır. Histopatolojik olarak onkositik sitoplazmalı çok tabakalı kolumnar hücrelerin endofitik ve ekzofitik gelişimi görülmüştür. İntraepitelyal nötrofil lökositler ile dolu küçük kistik yapılar (mikroabse formasyonu) da dikkati çekmiştir. Stroma, inflamatuvar hücreler içeren ödemli, fibrotik görünümde saptanmıştır. Patolojik tanı “Onkositik Tipte Sinonazal Papillom”dur. Postoperatif dönemde komplikasyon görülmemiştir ve bir yıldır takipte olan hastada rekürrens bulgusu da olmamıştır. Bu olgu, nadir görülmesinin yanı sıra bu tümör subtipi için nadir olan yaygın tutulum alanları ile ortaya çıkması nedeniyle literatür bilgileri eşliğinde sunulmuştur.

Anahtar Kelimeler

Sinonazal papillom, onkositik tip, sfenoid sinüs

A Rare Entity: Sinonasal Oncocytic Papilloma with Extensive Involvement

Öz

Papillomas are benign epithelial tumors of the sinonasal tract. Sinonasal papillomas are rarely seen among head and neck tumors and originate from the Schneiderian membrane. There are three histopathological types as exophytic, inverted and oncocytic. Oncocytic type is the rarest histopathological type. In this presentation, that was presented a case of oncocytic type sinonasal papilloma with widespread involvement in a 69-year-old male patient. A mass was detected in the left nasal cavity in radiographs taken six years ago due to trauma. Because the patient did not accept treatment, the mass grew to large sizes over time and caused significant obstruction. Due to widespread involvement of the mass, wide mass excision was performed. Histopathologically, endophytic and exophytic development of multilayered columnar cells with oncocytic cytoplasm was observed. Small cystic structures (microabscess formation) filled with intraepithelial neutrophil leukocytes were also noted. The stroma was found to have an edematous, fibrotic appearance containing inflammatory cells. The pathological diagnosis is "Oncocytic Type Sinonasal Papilloma". No complications were observed in the postoperative period, and there was no sign of recurrence in the patient who was followed up for one year. This case is presented with literature information due to its rarity and the fact that it presents with widespread involvement areas, which is rare for this tumor subtype.

Anahtar Kelimeler

Sinonasal papilloma, oncocytic type, sphenoid sinüs.

Kaynakça

• Hyams VJ. Papillomas of the nasal cavity and paranasal sinuses. A clinicopathological study of 315 cases. Ann Otol Rhinol Laryngol. 1971;80(2):192e206.
• Kaufman MR, Brandwein MS, Lawson W. Sinonasal Papillomas: clinicopathologic review of 40 patients with inverted and oncocytic Schneiderian papillomas. Laryngoscope. 2002;112(8):1372e7.
• Vorasubin N, Vira D, Suh JD, Bhuta S, Wang MB. Schneiderian papillomas: comparative review of exophytic, oncocytic, and inverted types. Am J Rhinol Allergy. 2013;27(4):287-92.
• Barnes L, Bedetti C. Oncocytic Schneiderian Papilloma: a reappraisal of cylindrical cell papilloma. Hum Pathol. 1984;15(4):344-51.
• Chee LW, Sethi DS. The endoscopic management of sinonasal inverted papillomas. Clin Otolaryngol Allied Sci. 1999;24:61-6.
• Lee JT, Bhuta S, Lufkin R, Castro DJ. Isolated inverting papilloma of the sphenoid sinus. Laryngoscope. 2003;113:41-4.
• El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ. WHO Classification of Head and Neck Tumours, 4th Edition, Lyon (France): International Agency for Research on Cancer; 2017. 230 p.
• Cunningham MJ, Brantley S, Barnes L, Schramm VL Jr. Oncocytic Schneiderian papilloma in a young adult: a rare diagnosis. Otolaryngol Head Neck Surg. 1987;97:47-51.
• Faizah AR, Mazita A, Marina MB, Jeevanan J, Isa MR. Oncocytic Schneiderian Papilloma: a rare sinonasal papilloma removed via endoscopic medial maxillectomy. Med&Health. 2010;5(1):55-9.
• Öztürk E, Başaran B, Yılmazbayhan D, Keles N. Bilateral oncocytic-type Schneiderian papilloma in a pediatric patient. Otolaryngology Case Reports. 2017:3:15-7.
• Karpischenko SA, Vereschagina OE, Stancheva OA, Bibik PR, Kaplun DI, Bogachev MI, et all. Case report: Oncocytic Schneiderian papilloma originating from the sphenoid sinus. Front Med (Lausanne). 2022;9:621705.
• Lilja M, Viitasalo S, Hytönen M, Haapaniemi A, Hagström J, Mäkitie A. Sinonasal oncocytic papilloma-a series of 20 cases with special emphasis on recurrences. Laryngoscope Investig Otolaryngol. 2019;4(6):567-72.
• Re M, Gioacchini FM, Bajraktari A, Tomasetti M, Kaleci S, Rubini C, et all. Malignant transformation of sinonasal inverted papilloma and related genetic alterations: a systematic review. Eur Arch Otorhinolaryngol. 2017;274(8):2991-3000.
• Kapadia SB, Barnes L, Pelzman K, Mirani N, Heffner DK, Bedetti C. Carcinoma ex oncocytic Schneiderian (cylindrical cell) papilloma. Am J Otolaryngol. 1993;14:332-8.