Benign tumours

Benign tumours

• Simple papillomas or viral warts can grow inside the nasal vestibule. They can be confused with carcinomas and are best excised for histological diagnosis. Osteomas of the nasal skeleton are not uncommon and are often detected on radiology as an incidental finding ( Figure 51.55 ). In symptomatic individuals the osteoma can be removed endoscopically or via an open procedure. Inverted (transitional cell) papillomas can occur in both the nasal cavity and the nasal sinuses. T hey are inverted papillomas because histologically the hyperplastic epithelium inverts into the under lying stroma. The papillomas are covered with transitional epithelium. Calcification within the tumour may be seen on CT along with sclerosis of the bone at the margins of the growth ( Figure 51.56 ). Inverted papillomas can undergo malignant change. Full surgical resection is required, and this can usually be performed endoscopically .

Figure 51.55 Coronal computed tomography (CT) scan showing an osteoma in the left anterior ethmoid sinus adjacent to the orbit The second coronal CT scan is following endoscopic excision of the osteoma (b) . Figure 51.56 Coronal computed tomography scan showing an extensive inverted papilloma involving the left maxillary sinus; arrow indicates calci /f_i cation within the tumour. Figure 51.57 Squamous cell carcinoma of the nasal septum.

Benign tumours

• Simple papillomas or viral warts can grow inside the nasal vestibule. They can be confused with carcinomas and are best excised for histological diagnosis. Osteomas of the nasal skeleton are not uncommon and are often detected on radiology as an incidental finding ( Figure 51.55 ). In symptomatic individuals the osteoma can be removed endoscopically or via an open procedure. Inverted (transitional cell) papillomas can occur in both the nasal cavity and the nasal sinuses. T hey are inverted papillomas because histologically the hyperplastic epithelium inverts into the under lying stroma. The papillomas are covered with transitional epithelium. Calcification within the tumour may be seen on CT along with sclerosis of the bone at the margins of the growth ( Figure 51.56 ). Inverted papillomas can undergo malignant change. Full surgical resection is required, and this can usually be performed endoscopically .

Figure 51.55 Coronal computed tomography (CT) scan showing an osteoma in the left anterior ethmoid sinus adjacent to the orbit The second coronal CT scan is following endoscopic excision of the osteoma (b) . Figure 51.56 Coronal computed tomography scan showing an extensive inverted papilloma involving the left maxillary sinus; arrow indicates calci /f_i cation within the tumour. Figure 51.57 Squamous cell carcinoma of the nasal septum.