ORAL HAIRY POLYP IN A TEENAGER: CASE REPORT AND LITERATURE REVIEW.

OBJECTIVE: To report an unusual case of oral hairy polyp (HP) and review the literature, providing epidemiological, clinical and histopathological information on this disease. CASE DESCRIPTION: A 12-year-old male patient was referred to a Stomatology department with a nodule in the posterior midline of the tongue. The patient did not know exactly when it arose or whether it had grown since then. Clinical exam revealed a bulky and mobile pedunculated mass lesion on the dorsum of the tongue, with a diameter of approximately 1 cm. The patient's mother reported no previous health problem. An excisional biopsy was performed, the surgical specimen was sent for anatomopathological analysis, and the findings were compatible with the diagnosis of HP. COMMENTS: Hairy polyp is a rare lesion, especially in the oral region. The literature search revealed only 10 case reports of oral HP published between January 1999 and January 2019, and they revealed a predominance of the disease in female newborns. Two uncommon facts were presented in this case: the patient was male and diagnosis was made at 12 years old.

Oral hairy polyp in a teenager: case report and literature review / Pólipo piloso oral em um adolescente: relato de caso e revisão de literatura

ABSTRACT Objective: To report an unusual case of oral hairy polyp (HP) and review the literature, providing epidemiological, clinical and histopathological information on this disease. Case description: A 12-year-old male patient was referred to a Stomatology department with a nodule in the posterior midline of the tongue. The patient did not know exactly when it arose or whether it had grown since then. Clinical exam revealed a bulky and mobile pedunculated mass lesion on the dorsum of the tongue, with a diameter of approximately 1 cm. The patient's mother reported no previous health problem. An excisional biopsy was performed, the surgical specimen was sent for anatomopathological analysis, and the findings were compatible with the diagnosis of HP. Comments: Hairy polyp is a rare lesion, especially in the oral region. The literature search revealed only 10 case reports of oral HP published between January 1999 and January 2019, and they revealed a predominance of the disease in female newborns. Two uncommon facts were presented in this case: the patient was male and diagnosis was made at 12 years old.

RESUMO Objetivo: Relatar um caso incomum de pólipo piloso (PP) oral e revisar a literatura para trazer informações epidemiológicas, clínicas e histopatológicas acerca da doença. Descrição do caso: Paciente do sexo masculino, 12 anos de idade, encaminhado ao Departamento de Estomatologia com nódulo na região posterior de linha média da língua. O paciente não soube relatar quando surgiu a lesão e se ela havia crescido desde então. O exame clínico revelou massa pedunculada, volumosa e móvel no dorso da língua, medindo aproximadamente 1,0 cm de diâmetro. A mãe do paciente relatou que ele nunca havia tido nenhum problema de saúde anterior. Foi realizada biópsia excisional e o material foi enviado para análise anatomopatológica, sendo os achados compatíveis com o diagnóstico de PP. Comentários: O pólipo piloso é uma lesão rara, especialmente na região oral. A pesquisa bibliográfica revelou apenas dez relatos de casos de PP oral, publicados entre janeiro de 1999 e janeiro de 2019, sendo observada predominância da doença em recém-nascidos do sexo feminino. Dois fatos incomuns ocorreram neste caso: tratava-se de um paciente do sexo masculino e o diagnóstico se deu aos 12 anos de idade.

Unusual location of median raphe cyst presenting as perianal polyp: a case report.

Median raphe cysts (MRC) are uncommon, benign congenital lesions that may present anywhere in the midline between the urinary meatus and the anus, with the shaft of the penis and the glans penis being the most common sites. We report a 52-year-old man with median raphe cyst unusually located in perianal region and treated by surgical excision.

Congenital hairy polyp of the oropharynx presenting as an esophageal mass in a neonate, a case report and literature review.

PURPOSE: To review the literature of congenital hairy polyps and describe the clinical presentation, operative management, and histologic findings of a congenital hairy polyp arising from the palatopharyngeus muscle in a neonate with recurrent choking episodes. METHODS: Chart review of a 2-month-old male referred to a tertiary care pediatric hospital. RESULTS: We present a case of a 2-month-old male who presented to the emergency room with recurrent episodes of choking and vomiting. The patient was previously healthy with no prior medical or neonatal history. The parents noted a small fleshy mass in the patient's oropharynx that he would chew on and swallow after several minutes. However, on physical exam, there was no evidence of oropharyngeal mass. The patient did not have respiratory distress. Imaging revealed a 22×7×11mm oblong, fatty mass in the lower cervical and upper thoracic esophagus with a thin stalk extending proximally to the upper collapsed esophagus. Intraoperative recorded laryngoscopy revealed a pedunculated soft palate mass attached to the right superior palatopharyngeus muscle. Histopathology revealed ectodermal and mesodermal elements in a polypoid structure lined by keratinizing squamous epithelium with adnexal structures and central mature adipose tissue, consistent with congenital hairy polyp resembling an accessory tragus of the ear and branchial anomaly. At 6-week follow up, the patient was doing well and gaining weight appropriately with no further choking episodes. There was no evidence of velopharyngeal dysfunction on follow up exam. The surgical site was completely healed and there was no evidence of recurrence. DISCUSSION: Congenital hairy polyps of the naso- and oropharynx are rare but may present as airway or esophageal masses, causing respiratory distress or choking episodes in a pediatric patient. The pathologic findings of keratinizing squamous epithelium, adnexal structures, adipose and cartilage tissues resemble congenital accessory tragus and may be considered a branchial arch anomaly.

Hairy Polyp of the Nasopharynx Arising from the Eustachian Tube.

Hairy polyps of the nasopharynx display characteristic radiological imaging findings, including the presence of fat in the polypoid mass. Furthermore, diagnostic imaging is useful for delineating the site of origin of these lesions, which can facilitate surgical planning. For instance hairy polyps that arise from the right Eustachian tube can be amputated via a trans-nasal approach with endoscopy, but may necessitate a two stage approach in order to avoid injury to critical structures, such as the internal carotid artery. On histology, hairy polyps comprise an outer keratinizing squamous epithelium with adnexal tissue, including hair follicles, and central fibroadipose and cartilaginous tissue. These features are exemplified in this sine qua non radiology-pathology correlation article.

Congenital hairy polyp and autoamputation in an infant with acute otitis media.

Hairy polyp is a rare, benign tumor that frequently localizes in the nasopharynx and oropharynx. The embryogenesis of hairy polyp is not known precisely. The clinical profile can vary depending on the size and location of the tumor. In this report, we present a case with hairy polyp who was admitted with acute otitis media and completely recovered after spontaneous autoamputation.

Congenital urethral polyps in girls: as a differential diagnosis of interlabial masses.

STUDY OBJECTIVE: To present the clinical appearance, differential diagnosis, long-term follow-up, and the surgical result of single-center experience with female urethral polyps presenting as an interlabial mass, and to report the common causes of interlabial masses in infants. DESIGN: All 12 girls who presented with an interlabial mass and intermittent bleeding have been included in this study; however, the benign urethral polyps are discussed in detail and are the subject of this study. SETTING: All patients were referred to our national referral pediatric urology center with initial impression of vaginal bleeding; however, rhabdomyosarcoma of bladder and urethra (n = 2) or vagina (n = 3) and urethral polyp (n = 7) was the final diagnosis. PARTICIPANTS: The records of 12 girls who presented with external genitalia bleeding were retrospectively reviewed. Among them, 7 had fibroepithelial polyps and underwent initial polypectomy between 2001 and 2011with mean age of 21.5 months (range: 1-90 mo). All girls underwent endoscopic surgical removal of polyps. MAIN OUTCOME MEASURES: No postoperative polyp recurrence was observed following endoscopic polyp resection. RESULTS: The postoperative period was uneventful except in 1 girl who had immediate postoperative urethral bleeding which stopped spontaneously. There was no major complication or polyp recurrence after operation during the long-term follow-up. CONCLUSIONS: The interlabial mass must be considered as a urethral polyp and should be differentiated from the vaginal rhabdomyosarcoma with protrusion of vaginal tumor from the vaginal outlet or other benign lesions. Physical examination in frog legged position or examination under anesthesia with urethrocystoscopy may confirm the final diagnosis.

Congenital urethral polyps in children: report of 18 patients and review of literature.

BACKGROUND/PURPOSE: To evaluate the presentation, diagnosis and management of congenital urethral polyps (CUP) in children and to report the results of the endoscopic resection of polyp with long-term follow-up. METHODS: Between April 1995 to March 2010, 18 children (14 boys, 4 girls) with CUP were treated. The most common presentation was urinary outflow obstruction/retention, hematuria or protruding polyp from the urethra meatus in girls. Six patients presented with vesicoureteral reflux (VUR). All children (except one) underwent a transurethral resection of the CUP. RESULTS: Following the endoscopic resection of the polyps, there was no polyp recurrence, and all patients became symptom-free. The children exhibited no reflux, urinary retention, hematuria or urinary tract infection (UTI) following endoscopic management. Abnormal uroflowmetry patterns returned to normal following the resection of the polyp for one year after the operation. CONCLUSIONS: Urethral polyps must be considered in every child with history of triad of recurrent intermittent urinary retention, hematuria and lower urinary tract symptoms. The cure can be achieved in all cases by an endoscopic approach. This type of tumor is always benign and very rarely recurs, unless the pedicle stalk is not resected. The endoscopic management of reflux is unnecessary in this group of patients due to their natural history of secondary reflux.

Posterior urethral polyp with type I posterior urethral valves: a rare association in a neonate.

Urethral polyp is a rare cause of bladder outlet obstruction, voiding dysfunction, and hematuria in the pediatric age group. Urethral polyps are rarely associated with other congenital urinary tract anomalies. In this study, we report a case of solitary posterior urethral polyp with type I posterior urethral valve in a 7-day-old neonate presented with urinary retention and deranged renal function. The polyp was diagnosed on cystoscopy. Transurethral resection of the polyp with posterior urethral valve fulguration was performed. Pathologic assessment revealed a fibroepithelial lesion, which was consistent with congenital posterior urethral polyp.

Congenital urethral polyps in the pediatric population.

Congenital urethral polyps are a rare entity. Most commonly, they present as benign posterior urethral growths in the pediatric male patient. However, reports of urethral polyps in female patients or even those with an anterior urethral location can also be found in the literature. Patients can present with a spectrum of symptoms including dysuria, hematuria, and obstructive type urinary complaints. Diagnosis in these cases includes a combination of medical imaging (e.g. ultrasound, fluoroscopic, CT or MRI), direct endoscopic visualization, and final surgical pathology. Treatment involves surgical removal either via an endoscopic or open approach.

Hairy polyp can be lethal even when small in size.

A case of sudden cardiopulmonary arrest in a 3-month-old girl is presented. The patient had barely recovered from hypoxic encephalopathy when she presented with repeated respiratory distress. Computed tomography and endoscopic analysis revealed a shiny polyp in the lateral wall of the nasopharynx, and this polyp was suspected to be the main cause of respiratory distress. After referral to our hospital, surgical removal was performed, and the histopathological diagnosis was hairy polyp. Hairy polyp is a rare congenital benign tumor that sometimes induces respiratory distress. This polyp can potentially induce a life-threatening event. In a systematic review of 40 reported cases, polyps of ≤ 3.0 cm in diameter have a higher risk of respiratory distress than do those >3.0 cm in diameter (P = 0.01). Small hairy polyps may be lethal because of delayed diagnosis. To locate small hairy polyps, physicians should not hesitate to perform further examination because there is the possibility of oversight with only physical examination.

A case of congenital orbital fibroepithelial polyp.

Fibroepithelial polyp (FEP) is a benign tumor of mesodermal origin, composed of varying amounts of stroma covered by epithelium. The skin and the genitourinary tract are the most common sites of FEP. Uncommon locations of FEP include the inferior turbinate of the nasal cavity, bronchi, and the pharynx. To date, there has been no report of orbital FEP. The authors describe a patient with congenital orbital FEP arising from the lateral canthal area. This congenital FEP was completely excised successfully through an anterior orbitotomy without any complications, with no evidence of recurrence after 25 months.

Hairy polyp of the oropharynx in association with a first branchial arch sinus.

OBJECTIVES: Hairy polyps are rare, congenital malformations of the oropharynx and nasopharynx. To date, approximately 145 cases have been reported. However, the histogenesis of these lesions remains unclear. CASE REPORT: We report the case of a 2-day-old neonate presenting with a hairy polyp attached to the left palate, who re-presented aged 16 months with a discharging first branchial arch sinus. CONCLUSION: We propose this case as supporting evidence for the theory that hairy polyps are a malformation of the first branchial arch system.

Congenital hairy polyp of the soft palate.

Hairy polyp is an unusual developmental malformation that is most frequently seen as a pedunculated tumor in the neonate. They are benign lesions containing elements of both ectodermal and mesodermal origin. The symptoms of hairy polyps relate both to their location and their size. Larger lesions produce symptoms due to feeding difficulties and airway obstruction while smaller lesions cause intermittent symptoms resulting from a ball-valve type of obstruction. We present two cases of a soft palate hairy polyp causing respiratory and feeding difficulties and review the literature.