Sinonasal seromucinous hamartoma

Last revised by Lincoln J Lim on 2 Aug 2023

Sinonasal seromucinous hamartomas (SSH) are benign sinonasal neoplasms.

Sinonasal seromucinous hamartomas are rare, with approximately 25 cases reported since 1974 1. They are more common in middle-aged adults with a mean in the 6th decade and a slight female predilection (1.5:1) 3,4. While these are usually seen in the adult population, they have been described in patients as young as 14 2.

Clinical presentation can vary, but most patients present with unilateral nasal obstruction 3,4. However, some patients may also present with nasal discharge, choking sensation, epistaxis, or asymptomatic. Masses have ranged in size from 0.6 to 6.0 cm 5.

Although imaging studies are helpful in the diagnosis, ultimately, histology is required. 

Microscopically, these lesions are covered by ciliated respiratory or cuboidal epithelia with invaginations and variable glandular and cystic stroma 2,3. Mitotic figures, cellular atypia, and necrosis are often absent 5. However, eosinophilic, or mucinous cells may be present 4.

In most patients, cases have arisen from the posterior nasal cavity medial to the middle turbinate 5.

MR (and CT to a lesser extent) are beneficial in determining localization of disease. These lesions most commonly appear as lobulated masses in the posterior nasal cavity or nasopharynx with hyperintense T2 signal. They are not associated with invasion into adjacent tissue 1,6.

These tumors are benign neoplasms. Surgery is often curative and there has only been one reported case of recurrence 2.

Differential diagnosis include:

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