Nasopharyngeal hairy polyp with recurrence in the middle ear

A 6-year-old girl was referred to The Johns Hopkins Hospital for a suspected congenital cholesteatoma. The lesion was determined to be a recurrence of a nasopharyngeal hairy polyp removed in the postnatal period. Simple excision is normally regarded as curative: malignant transformation and local recurrence do not occur. Our case is exceptional in that incomplete excision of the nasopharyngeal polyp was followed by re-growth and extension into the middle ear over a 6-year period. Thus, not all hairy polyps are static lesions. Indeed, this case documents progressive growth of a hairy polyp during physical development of a child, and indicates a potential for local recurrence following incomplete excision. A review of possible etiologies is conducted.