Cholesterol granuloma in an antrochoanal polyp. A rare lesion in children / Granuloma por colesterol en un pólipo antrocoanal. Una rara lesión en la edad pediátrica

Antrochoanal polyps (ACPs) are an infrequent clinical entity. Cholesterol granulomas (CGs) are commonly associated with chronic middle ear disease but are rare in the paranasal sinuses. We describe a case of a 10-year-old girl with a concomitant CG in an ACP which was surgically excised by nasosinusal endoscopic surgery. To our knowledge, there are only five previously published cases of CGs in ACPs and of these, only two were pediatric cases. We describe a third case in the youngest patient yet reported. Increased intrasinus pressure may affect venous and lymphatic drainage, leading to hemorrhages with hemolysis and deposition of cholesterol crystals and their esters initiating the formation of granulomas in the polyp. In addition, the insufficient lymphatic drainage prevents the complete elimination of lipids, contributing to the formation of cholesterol granulomas. The treatment and the outcome of an ACP associated with a CG are the same as for usual ACPs

Los pólipos antrocoanales (PAC) son una entidad clínica infrecuente. Los granulomas de colesterol (GC) se asocian comúnmente con la enfermedad crónica del oído medio, pero son raros en los senos paranasales. En este artículo describimos un caso de GC concomitante con un PAC de una niña de 10 años que fue sometida a extirpación quirúrgica nasosinusal endoscópica. En nuestro conocimiento, solamente 5 casos de GC asociados a PAC han sido publicados. De ellos solamente 2 eran casos pediátricos. En el presente artículo describimos un tercer caso que representa el paciente más joven publicado hasta la fecha. El aumento de la presión en la cavidad del seno puede afectar al drenaje venoso y linfático conduciendo a hemorragias con hemólisis y depósito de cristales de colesterol y sus ésteres iniciando la formación de granulomas en el pólipo. Además, el drenaje linfático insuficiente impide la eliminación completa de los lípidos contribuyendo a la formación de granulomas por colesterol. El tratamiento y la evolución del PAC asociado a GC son similares a los del PAC habitual

Cholesterol granuloma in an antrochoanal polyp. A rare lesion in children.

Antrochoanal polyps (ACPs) are an infrequent clinical entity. Cholesterol granulomas (CGs) are commonly associated with chronic middle ear disease but are rare in the paranasal sinuses. We describe a case of a 10-year-old girl with a concomitant CG in an ACP which was surgically excised by nasosinusal endoscopic surgery. To our knowledge, there are only five previously published cases of CGs in ACPs and of these, only two were pediatric cases. We describe a third case in the youngest patient yet reported. Increased intrasinus pressure may affect venous and lymphatic drainage, leading to hemorrhages with hemolysis and deposition of cholesterol crystals and their esters initiating the formation of granulomas in the polyp. In addition, the insufficient lymphatic drainage prevents the complete elimination of lipids, contributing to the formation of cholesterol granulomas. The treatment and the outcome of an ACP associated with a CG are the same as for usual ACPs.