Nasal chondromesynchymal hamartoma presenting in an adolescent

Nasal chondromesenchymal hamartoma (NCMH) is extremely uncommon primary benign cartilaginous growth of the nasal and paranasal sinuses. To date, it has been reported almost exclusively in infancy. We report a NCMH in a 16-year-old patient who presented with an asymptomatic, fixed swelling on the left side of the nose approximately 2x2 cm in size. Computed tomography (CT) and magnetic resonance imaging (MRI) of the nose, paranasal sinuses and neck confirmed a heterogeneous, calcified polypoidal mass protruding caudally into the left nasal cavity. After an initial inconclusive incisional biopsy, the patient underwent a complete radical resection, with staged reconstruction of the full nasal defect using septal mucosal flap, conchal cartilage graft and forehead skin flap. Histological examination of the resected specimen confirmed NCMH, which, we believe, had probably been present and undetected for many years. This report greatly extends the age at which NCMH may be entertained as part of the differential diagnosis of cartilaginous lesions of the nose and paranasal sinuses.