Int Arch Otorhinolaryngol 2014; 18(02): 213-216
DOI: 10.1055/s-0033-1351675
Case Report
Thieme Publicações Ltda Rio de Janeiro, Brazil

Subcutaneous Cavernous Hemangioma in the Nasal Dorsum: Report of Case Treated with Endoscopic Rhinoplasty

Jan Alessandro Socher
1  Department of Otorhinolaryngology, Regional University of Blumenau Foundation (Fundação Universidade Regional de Bumenau–FURB), Blumenau/SC, Brazil
,
Maurício F. de Sá Marchi
2  Department of Medicine, Regional University of Blumenau Foundation (Fundação Universidade Regional de Bumenau–FURB), Blumenau/SC, Brazil
,
Jeniffer C. Kozechen Rickli
2  Department of Medicine, Regional University of Blumenau Foundation (Fundação Universidade Regional de Bumenau–FURB), Blumenau/SC, Brazil
› Author Affiliations
Further Information

Publication History

30 September 2012

15 April 2013

Publication Date:
25 October 2013 (online)

  

Abstract

Introduction Hemangiomas are vascular malformations, with slow blood flow, that can occur in any part on the body. They are more common in women and, predominantly, are isolated lesions. The malformation does not spontaneously regress. Subcutaneous hemangioma is a rare variant with an aggressive growth pattern that sometimes recurs after excision.

Objective Case report of a subcutaneous cavernous hemangioma in the nasal dorsum treated with endoscopic rhinoplasty.

Case Report A 27-year-old woman had a fibroelastic tumor mass in the midline of the nasal dorsum, which was pulsatile; she had obstruction and nasal congestion with associated rhinorrhea, with evolution and worsening over the previous 2 years. Computed tomography showed a tumor demarcated in the nasal dorsum without evidence of intracranial communication. Endoscopic rhinoplasty with septoplasty and associated paranasal sinus sinusectomy was performed without arteriography embolization, sclerotherapy, or laser. Pathologic diagnosis showed cavernous hemangioma. Postoperative follow-up shows no recurrence at 3 years.

Discussion This case presented with atypical features, thus making the diagnosis a challenge. Imaging studies were required to confirm the vascular nature of the tumor. Excisional biopsy is the procedure of choice for pathologic examination. Subcutaneous hemangiomas never involute and always need treatment. The surgical approach is exceptional because there was no preoperative diagnosis. In addition, the closed technique provided best aesthetic results in this case.

Conclusion Endoscopic rhinoplasty is suitable for nasal dorsum tumor resection and has superior aesthetic result to open techniques.