[Congenital hairy polyp of the nasopharynx--a case report]

Hairy polyps are very rare benign tumors that can occur anywhere in the body, and they are the most common congenital nasopharyngeal masses.

A two-day-old full-term female was admitted to the newborn Special Care Unit with noisy breathing, intermittent upper airway obstruction and feeding difficulty. A 3.4 kg infant was born by spontaneous vaginal delivery to a healthy mother, following a normal pregnancy. On admission, she presented with noisy inspiratory breathing which was louder and more labored in prone position. Flexible endoscopy showed a pale sausage-like mass protruding from nasopharynx just behind the soft palate, to the oropharynx and back. A computed tomography scan showed a 1.8 cm round mass in the right nasopharynx, with central fat density and no intracranial communication. The mass was excised transorally with no evidence of a residual tumor. The infant made a full and uneventful postoperative recovery.

Hairy polyps usually occur as isolated defects and they are not associated with other congenital anomalies. Genetic predisposition has not been established. It does not have malignant alteration. However, there is some confusion about the histological classification of these lesions. One theory supports the idea that hairy polyps originate from disturbed development of stomodeum in the 28th week of gestation and regression of the nasopharyngeal membrane. The second theory supports the idea of origin from the first or second bronchial arch. Probably the best assumption would be that it develops as a special and unique entity.

Hairy polyp is an unusual malformation that most frequently appears during the first days after birth. Complete resection provides permanent cure.