Unusual presentation of an extensive antrochoanal polyp extending to the hypopharynx: a rare case report and literature review
Year: 2026
Type: article
Study design: Case Report
Abstract: Antrochoanal polyps (ACPs) are benign growths that typically arise from the maxillary sinus, extending through the choana and reaching the nasopharynx or oropharynx. Extension to the level of the upper border of the hypopharynx is exceedingly rare and has been documented in very few reports. We report a highly unusual case of a 32-year-old male who presented to the Emergency Department with the sudden onset of dysphagia and choking on liquids. Oral cavity and oropharyngeal examination revealed a large midline mass protruding from the nasopharynx, extending inferiorly to the upper border of the hypopharynx. Contrast-enhanced computed tomography of the neck demonstrated a well-circumscribed, homogeneous, low-density, non-enhancing, non-septated midline cystic lesion in the posterior nasopharynx and oropharynx (2.61 × 2.91 × 6.3 cm), with an incidental left maxillary sinus retention cyst. The patient underwent functional endoscopic sinus surgery the following day; the polyp was found to originate from the mucosa of the right maxillary sinus osteomeatal complex and was completely excised and delivered through the oral cavity. Histopathological examination of the excised specimen revealed a polypoid lesion lined by ciliated pseudostratified columnar epithelium with squamous metaplasia, overlying a markedly oedematous, hypocellular stroma with a myxomatous background, prominent thin-walled blood vessels, and a scattered mixed inflammatory infiltrate of lymphocytes, plasma cells, and rare eosinophils. At six weeks of follow-up, the patient was asymptomatic, and repeat endoscopy demonstrated a patent right maxillary sinus with no residual polyp. This case highlights the importance of early endoscopic evaluation and surgical excision in cases of ACPs with unusual extensions, ensuring effective management and favourable outcomes.
Source: Journal of Surgical Case Reports
Institutions: King Saud Medical City, Ministry of Health
Language: English
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,000
OpenAlex ID: W7225757071