Respiratory Epithelial Adenomatoid Hamartoma (reah): Uncommon Nasal Polyps Masquerader - Evaluation at Hospital Chancellor Tuanku Muhriz, Malaysia
Year: 2025
Type: preprint
Abstract: Background Respiratory epithelial adenomatoid hamartomas (REAH) are uncommon, benign glandular growths occurring in the nasal cavity, paranasal sinuses, and nasopharynx. This study seeks to deepen our knowledge of REAH by presenting eight cases along with a review of relevant literature. Methods A retrospective review was performed on all patients with biopsy-proven REAH from 2012 – 2023. Lesions were biopsied endoscopically and sent for histopathological analysis. Data was collected with respect to demographic (age, gender), clinical presentation (symptoms, duration, endoscopic findings), imaging, histopathology, treatment, and outcomes. Results Between 2012 and 2023, our center identified 8 cases of histopathologically confirmed REAH out of 339 nasal biopsies (2.4%), with an equal distribution of men (n = 4) and women (n = 4), and a mean age of 55.6 years. All patients presented with nasal obstruction, with two experiencing additional symptoms: one had epistaxis and another had anosmia. Three patients (37.5%) had isolated, unilateral REAH, while five (62.5%) had REAH associated with chronic rhinosinusitis, presenting both unilaterally and bilaterally. All underwent successful endoscopic excision, with no recurrence, and 5 (62.5%) had radiological evaluation showing hypodense lesions without bony erosion. Conclusion REAH is a benign glandular proliferation of the nasal cavity, confirmed through histopathology, and often curable with surgical resection. Clinically, it presents as rubbery, non-vascular polypoid masses, while radiologically, it appears as exophytic homogeneous lesions without bony erosion and olfactory cleft widening over 10 mm. Recognizing these features can help prevent unnecessary or overly aggressive treatments.
Institution: National University of Malaysia
Language: English
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4415245496
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