Respiratory epithelial adenomatoid hamartoma: Minimally invasive surgery of an endoscopic and radiological finding in maxillary sinus mimicking an inverted papilloma

Respiratory epithelial adenomatoid hamartoma (REAH) is a benign entity characterized by an abnormal proliferation of glandular tissue surrounded by a thick eosinophilic basement membrane within ciliated respiratory epithelium with no evidence of atypical or metaplastic changes in the squamous cells. An 84 years patient, non-smoker, with in treatment hypertension and depression reported a 3-month history of progressive right nasal obstruction, mucopurulent rhinorrhea, unilateral purulent post-nasal discharge and unilateral anosmia. Endoscopy showed a polypoidal masse, with no presence of nasal polyposis. The lesion, originating from the maxillary sinus, arose from middle meatus and extended inferiority up to the inferior turbinate.During an endoscopic minimally-invasive surgical procedure, we performed the complete excision of the whole lesion, through the use of micro-instruments and debrider technology. The patient underwent regular check-up after 3, 6 and 12 months: endoscopic and radiological evaluation showed no relapse of the disease. Although REAH is a neoplastic pathology, the intrinsic characteristics of benignity and the typical limited and non-infiltrating diffusion allow a minimally invasive and conservative surgical approach without evidence of recurrence.