Naso-oropharyngeal choristoma (hairy polyps): an overview and current update on presentation, management, origin and related controversies.

This review presents a comprehensive and updated overview of bigerminal choristomas (hairy polyps) of naso-oropharynx/oral cavity, and discusses the controversies related to nosology and origin from a clinico-embryologic perspective. English-language texts of the last 25 years (January 1989-January 2014) were collected from the PubMed/MEDLINE database using the given keywords. Of the 330 records, 64 full-text articles (mostly case reports/series) were selected, incorporating clinical data from 78 patients, after screening through duplicates and the given exclusion criteria. With the available evidence, hairy polyps appear more common than generally believed, and are increasingly being recognized as an important, often-missed cause of respiratory distress and feeding difficulty in neonates and infants. Such a child without any apparent cause should be examined with flexible nasopharyngoscope to specifically look for hairy polyps which might be life-threatening, especially when small. The female preponderance as believed today has been found to be an overestimation in this review. These lesions are characteristically composed of mature ectodermal and mesodermal tissue derivatives presenting as heterotopic masses, hence termed choristoma. However, little is known about their origin, and whether they are developmental malformations or primitive teratomas is debatable. Involvement of Eustachian tube and tonsils as predominant subsites and the speculated molecular embryogenesis link hairy polyps to the development of the first and second pharyngeal arches. They are exceptionally rare in adults, but form a distinct entity in this age-group and could be explained as delayed pluripotent cell morphogenesis or focal neoplastic malformations, keeping with the present-day understandings of the expanded "teratoma family".

Unusual case of soft palate hairy polyp causing airway obstruction and review of the literature.

Hairy polyps are rare benign tumors that are derived from 2 germ layers: ectoderm and mesoderm. Although location in the head and neck area is rare, the soft palate as the site of origin is even more unusual. The clinical presentation depends on the polyp's location and size. These masses can commonly cause respiratory and feeding difficulties. We present a case of a soft palate hairy polyp causing respiratory and feeding difficulties in a 6-month-old female infant and review the literature.

An umbilical polyp in an infant.

The persistence at birth of the omphalomesenteric (vitelline) duct may result in life-threatening consequences. Early identification of this congenital anomaly is essential for prompt surgical treatment to eliminate the risk of prolapse and herniation. A neonatal umbilical polyp may indicate the presence of an omphalomesenteric duct remnant. We describe the diagnosis and surgical treatment of an infant with an umbilical polyp. We also present an overview of the diagnosis and treatment of vitelline duct remnants and their associated anomalies.

Pólipos umbilicales y otras anomalías del conducto onfalomesentérico / Umbilical polyps and other abnormalities of the omphalomesenteric duct

El conducto onfalomesentérico es una estructura tubular que une el intestino primitivo con el saco vitelino del embrión. Normalmente esta estructura desaparece obliterándose completamente al final de la 5º o 6º semana de vida intrauterina, pero en ocasiones puede persistir ocasionando diferentes anomalías como fístulas, quistes vitelinos o pólipos umbilicales. Los pólipos son lesiones tumorales rojo brillante que se observan en la cicatriz umbilical tras la caída del cordón.Se presentan 10 casos de anomalías del cierre del conducto onfalomesentérico, de los cuales 7 fueron varones y 3 mujeres. 9 pacientes presentaron pólipos umbilicales, 2 de ellos con fístulas enterocutáneas, y una paciente un quiste vitelino. Las edades de consulta fueron desde los 4 días de vida hasta los 6 años de edad. En 8 pacientes se realizaron estudios histopatológicos, que evidenciaron mucosa gastrointestinal en contacto con epidermis, en 2 casos se realizaron estudios por imágenes contrastadas, encontrándose fístulas enterocutáneas, y en uno fue necesaria una laparotomía exploradora para llegar al diagnóstico. Es importante conocer estas anomalías umbilicales ya que por su embriogénesis, pueden asociarse con alguna de las otras alteraciones derivadas de la falla del cierre del conducto onfalomesentérico, las cuales pueden ocasionar consecuencias graves para el paciente, de no realizarse el diagnóstico oportuno y el tratamiento correcto (AU)

Umbilical polyp originating from urachal remnants.

Umbilical polyp is a rare disorder of the umbilical region in childhood. It is said to be the result of incomplete closure of the omphalomesenteric duct and presents as a red, moist umbilical mass after separation of the umbilical cord. Umbilical polyp originating from the urachus has not previously been reported. A 10-year-old boy with an umbilical polyp related to the urachus is presented to stress the possibility that umbilical polyps can originate not only from the omphalomesenteric duct but also from urachal remnants.

[A bizarre excrescence of the umbilicus in a 1-month-old child]. / Une excroissance bizarre de l'ombilic chez un enfant de un mois.

We report the case of an umbilical polyp, derived from omphalo-mesenteric remnants in an one-month-old female child. This rare abnormality results from a closure defect of the vitelline duct. The vitelline duct normally closes between the 5th and the 7th weeks of intra embryonic development but can lead to several pathologies in case of closure defects, giving rise to abdominal (Meckel diverticulum, vitelline cyst) or umbilical symptoms (umbilical fistula, umbilical sinus and umbilical polyp). These disorders have a 2% incidence, and may induce clinical symptoms of varied gravity ranging from clinical silence to acute abdomen. We seized the opportunity of this rare clinical observation to review the nosology of vitelline duct defects at the light of embryologic data.

Umbilical polyps.

We report three patients, ages 5 years, 3 years, and 4 days, with umbilical polyps. In the third child the polyp was associated with an umbilical enteric fistula. An umbilical polyp is the result of incomplete closure of the omphalomesenteric duct and becomes apparent after the umbilical cord is detached. It is a reddish tumor of a few millimeters; it seldom bleeds or is exudative. We consider it important to study every case in detail in order to exclude possible underlying embryologic anomalies such as Meckel's diverticulum and umbilical enteric fistula.

Obstructing polyps of the posterior urethra in boys: embryology and management.

Solitary fibrous polyps are in uncommon but important cause of obstructive uropathy, infection and hematuria in boys. The clinical presentation and management in 5 boys are discussed and the literature is reviewed. Emphasis is placed on the pitfalls in diagnosis and recent endoscopic techniques of treatment.