Abstract
To the Editor,
I read with great interest the case report “Respiratory Epithelial Adenomatoid Hamartoma: Expanding the Spectrum of Rare and Misleading Nasopharyngeal Lesions,” published online May 23, 2025, in Ear, Nose & Throat Journal. 1 In this article, the authors present a case of sinonasal respiratory epithelial adenomatoid hamartoma (REAH) supported by endoscopic findings and histopathologic confirmation. Although imaging was not employed in this case due to the lesion’s benign appearance, prior reports describe classic imaging features of REAH as demonstrating well-demarcated, nonerosive soft-tissue opacification. This case report adds valuable nuance to the differential diagnosis of unilateral nasal masses and reinforces that not every enhancing lesion indicates malignancy. The authors’ comparative analysis of REAH’s histopathologic features, summarized in Table 1 and contrasted with inverted papilloma cases in the literature, strengthens diagnostic clarity. Equally valuable is this report’s documentation of symptom resolution and the absence of recurrence over two years, which reinforces REAH’s benign nature and excellent prognosis following conservative excision.
From a medical student’s perspective, the report also highlights curricular blind spots in benign sinonasal pathology. Despite emerging evidence that REAH may be under-recognized in polypectomy specimens, dedicated teaching on this entity remains limited. Incorporating short, image-rich modules into gross anatomy and residency endoscopic-skills courses could sharpen pattern recognition and prevent unnecessary oncologic alarms. Beyond education, prospective multicenter registries that pair radiologic measurements such as olfactory cleft width and bone-remodeling indices with molecular profiling could help clarify whether chronic inflammation predisposes patients to hamartomatous change — or if REAH reflects a distinct developmental anomaly. Patient-facing implications are equally compelling: many individuals equate “mass” with “cancer,” yet plain-language materials on benign lesions are scarce and often written above a tenth-grade reading level. Leveraging large language models to generate sixth-grade-level brochures — then vetting them through board-certified otolaryngologists for accuracy — could reduce anxiety and improve shared decision-making, especially for underserved populations with lower baseline health literacy. Finally, the article underscores the value of multidisciplinary collaboration: routine radiology-pathology correlation conferences could not only refine diagnostic confidence but also generate fertile ground for case-based learning and research hypotheses.
Sincerely,
Footnotes
Acknowledgements
The authors used Grammarly to assist with grammar editing during manuscript preparation. No third-party writing or editorial service was used. The manuscript was written, edited, and submitted solely by the listed authors.
Ethical Considerations
This article does not contain any studies involving human participants or animals performed by any of the authors. No patient data were used, and no IRB approval was required.
Funding
The author received no financial support for the research, authorship, or publication of this article.
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research, authorship, or publication of this article.
Data Availability Statement
All data used in this article were obtained from publicly available sources. No new datasets were generated or analyzed during the current study.