Sažetak
Apstrakt
Uvod. Dlakavi polip je retka malformacija koja se sastoji od mezodermalnih i ektodermalnih elemenata. To je najčešći kongenitalni tumor nazofarinksa. Klinički simptomi zavise od veličine i lokalizacije polipa. Rana hirurška ekscizija rezultuje potpunim izlečenjem. Prikaz bolesnika. Dete je rođeno iz redovno kontrolisane trudnoće. Prenatalno, u 24. gestacijskoj nedelji, postavljena je sumnja na postojanje epulis gigantocellularis-a. Urađena je magnetna rezonanca i evidentirana masa koja je protudirala iz usne duplje. Odmah po rođenju je uočena tkivna formacija vezana za tvrdo nepce, koja prominira van usta, kao i rascep mekog nepca i jezika. U prvom danu života dete je intubirano i započeta je mehanička respiratorna potpora. U 4. danu života izvršena je traheostomija, dok je u 40. danu života tumorska masa u celini ekscidirana, uz rekonstrukciju postojećih deformiteta u usnoj duplji. Histopatološka analiza je utvrdila postojanje dlakavog polipa. U petom mesecu života deteta izvedena je perkutana endoskopska gastrostoma. Na početku druge godine života rascep nepca i jezika je hirurški korigovan. Po uspostavljanju adekvatnog gutanja sprovedena je dekanilacija i zatvorena traheostoma i u daljem toku gastrostoma. Zaključak. Iako je dlakavi polip redak tumor, mora biti uključen u diferencijalnu dijagnozu faringealnih masa u neonatalnom periodu. Ukoliko nema pridruženih anomalija i ukoliko je izvršena kompletna hirurška resekcija tumora, dalji tok i ishod lečenja je povoljan.
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Reference
REFERENCES
Budenz CL, Lesperance MM, Gebarski S. Hairy polyp of the pharynx obscured on physical examination by endotracheal tube, but diagnosed on brain imaging. Pediatr Radiol 2005; 35(11): 1107‒9.
Puricelli E, Barra MB, Hochhegger B, Ponzoni D, de Azambuja HV, Morganti MA, et al. Hairy polyp on the dorsum of the tongue. Head Face Med 2012; 8: 19.
Cheriathu JJ, Mohamed K, D'Souza IE, Shamseldeen M. Autoamputation of congenital hairy polyp in neonate with stridor and respiratory failure. WebmedCentral Paediatrics 2012; 3(5): WMC003379.
Christianson B, Ulualp SO, Koral K, Rekheja D, Deskin R. Congenital hairy polyp of the palatopharyngeus muscle. Case Rep Otolaryngol 2013; 2013: 374681.
Baljošević I, Minić P, Đuričić S, Šubarević V. Congenital hairy polyp of the nasopharynx: A case report. Med Pregl 2007; 60(3‒4): 191‒3. (Serbian)
Singh D, Darahwal A, Banjara H, Sarkar S. Hairy polip of the nasopharynx. AIJCR 2011; 4(3): 149‒51.
Dutta M, Roy S, Ghatak S. Naso-oropharyngeal choristoma (hairy polyps): An overview and current update on presenta-tion, management, origin and related controversies. Eur Arch Otorhinolaryngol 2015; 272(5): 1047‒59.
Arnold J. Ein Fall von congenitalem zusammengesetztem Li-pom der Zunge und des Pharynx mit Perforation in die Schädelhöhle. Virchows Arch (Pathol Anat) 1870; 50: 482‒516.
Kelly A, Bough ID, Luft JD, Conard K, Reilly JS, Tuttle D. Hairy polyp of the oropharynx: case report and literature review. J Pediatr Surg 1996; 31(5): 704‒6.
Simoni P, Wiatrak BJ, Kelly DR. Choristomatous polyps of the aural and pharyngeal regions: first simultaneous case. Int J Pe-diatr Otorhinolaryngol 2003; 67(2): 195‒9.
Coppit GL 3rd, Perkins JA, Manning SC. Nasopharyngeal tera-tomas and dermoids: A review of the literature and case series. Int J Pediatr Otorhinolaryngol 2000; 52(3): 219‒27.
Vranic S, Caughron SK, Djuricic S, Bilalovic N, Zaman S, Suljevic I, et al. Hamartomas, teratomas and teratocarcinosarcomas of the head and neck: Report of 3 new cases with clinico-pathologic correlation, cytogenetic analysis, and review of the literature. BMC Ear Nose Throat Disord 2008; 24(8): 8.
Aughton DJ, Sloan CT, Milad MP, Huang TE, Michael C, Harper C. Nasopharyngeal teratoma ('hairy polyp'), Dandy-Walker malformation, diaphragmatic hernia, and other anomalies in a female infant. J Med Genet 1990; 27(12): 788‒90.
Cone BM, Taweevisit M, Shenoda S, Sobol S, Schemankewitz E, She-hata BM. Pharyngeal hairy polyps: five new cases and review of the literature. Fetal Pediatr Pathol 2012; 31(3): 184‒9.
Richter A, Mysore K, Schady D, Chandy B. Congenital hairy polyp of the oropharynx presenting as an esophageal mass in a neonate, a case report and literature review. Int J Pediatr Otorhinolaryngol 2016; 80: 26‒9.
İsmi O, Görür K, Arpacı RB, Vayisoglu Y, Özcan C. Hairy polyp of the supratonsillar fossa causing intermittent airway obstruc-tion. Int Arch Otorhinolaryngol 2015; 19(1): 90‒2.
Koike Y, Uchida K, Inoue M, Ohtsu K, Tanaka T, Otake K, et al. Hairy polyp can be lethal even when small in size. Pediatr Int 2013; 55(3): 373‒6.
Kontopoulos EV, Gualtieri M, Quintero RA, Siristatidis C, Vrachnis N, Chrelias C. Successful in utero treatment of an oral teratoma via operative fetoscopy: case report and review of the literature. Am J Obstet Gynecol 2012; 207(1): e12‒5.
Laje P, Howell LJ, Johnson MP, Hedrick HL, Flake AW, Adzick SN. Perinatal management of congenital oropharyngeal tu-mors: the ex utero intrapartum treatment (EXIT) approach. J Pediatr Surg 2013; 48(10): 2005‒10.
Abraham RJ, Sau A, Maxwell D. A review of the EXIT (Ex utero Intrapartum Treatment) procedure. J Obstet Gynaecol 2010; 30(1): 1‒5.
De Caluwe D, Kealey SM, Hayes R, Puri P. Autoamputation of a congenital oropharyngeal hairy polyp. Pediatr Surg Int 2002; 18(5‒6): 548‒9.