Respiratory epithelial hamartoma – a case series and the importance of its diagnosis

Introduction Respiratory epithelial adenomatoid hamartomas (REAH) are benign growths that can occur in the nasal cavity. When mistaken for inflammatory nasal polyps, it can result in presumed poor treatment response. This case series and review outlines their clinical presentation and importance of its recognition.Methods Cases were retrospectively analysed from a single centre over a 12-month period. Imaging and histology results were analysed.Results Four cases were reviewed. All males in their 6th decade undergoing treatment for chronic rhinosinusitis with nasal polyps. All reported hyposmia, poor response to steroids and had a widened olfactory cleft on CT imaging. There was no recurrence following surgical resection.Conclusion Our findings are consistent with other case series. It is essential that clinicians are aware of REAH and consider it in patients who fit this clinical picture to manage expectations of treatments, in particular steroids and biologics. If undergoing sinus surgery, olfactory cleft histological sampling should be considered.