Unexpected tumor incidence in surgically removed unilateral and bilateral nasal polyps

The objective of the study was to investigate the postoperative tumor incidence on routine histopathologic examination of surgical specimens in patients who underwent endoscopic sinus surgery with the preoperative diagnosis of unilateral or bilateral nasal polyposis.

Patients who underwent endoscopic sinus surgery with the preoperative diagnosis of unilateral or bilateral nasal polyposis between 2000 and 2009 were included in the study as the 2 separate groups. In both groups, tumor incidence that had been noticed on routine postoperative histopathologic examination was recorded retrospectively. Patients who had a preoperative diagnosis other than nasal polyposis, determined on biopsy, were excluded.

Of 251 patients included, 197 had the preoperative diagnosis of bilateral nasal polyposis, and 54 had unilateral nasal polyposis. No tumor was diagnosed on postoperative histopathologic examinations in patients with preoperative bilateral nasal polyposis. Seven patients (12.96%) with the preoperative diagnosis of unilateral nasal polyposis had tumors on postoperative histopathologic examinations. Two of these 7 patients had malignant tumors that were reported preoperatively by intranasal biopsy as inflammatory polyps.

Diagnosis of a neoplasia is an extremely rare situation, unless there are special findings of tumor in patients with preoperative diagnosis of bilateral nasal polyposis. On the other hand, histopathologic examinations should be carried out in every case operated with preoperative diagnosis of unilateral nasal polyposis, as the tumor incidence is higher.