Endoscopic Management of true Hemangiopericytoma arising from the nasal septum: case study and literature review

Introduction:

Hemangiopericytomas are vascular neoplasms that are derived from Zimmerman's capillary pericytes. Of the paranasal sinuses, ethmoid and sphenoid sinuses are most commonly involved but in our case it arising only from the nasal septum.

Case Report:We report an uncommon case of 42 years old female who came to our university outpatient clinic suffering from unilateral right epistaxis.

The condition started with unilateral nasal bleedind and block. On examination, there was a fleshy polypoidal mass seen filling the entire right nasal cavity reaching the posterior choana.

Materials and methods:

A CT scan of the paranasal sinuses shows a soft-tissue mass with strong enhancement after contrast administration. MRI showed a solid isointense mass with strong contrast intake on T1-weighted imaging and varies from isointense to low intense on T2-weighted imaging. MRA of the mass show a vascular mass supplied by internal maxillary artery.

Biobsy and histopathology demonstrated tightly packed proliferated spindle cells surrounded by an intact reticulin sheaths with a stag horn pattern arrangement.

Result:

Endoscopic resection of the tumor without preoperative embolization with safety margin from the nasal septal perichondrium leaving the avascular nasal cartilage and follow up for six months with no recurrence.

Conclusion:

Hemangiopericytomas of the nasal cavity exhibit low malignant potential. The treatment of choice is wide surgical resection which is the only curative modality through open approaches but increased experience with endoscopic management of sinonasal tumors has led to a shift in management of Hemangiopericytomas.

Publication History

Publication Date:
18 April 2018 (online)