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Endoscopic resection of a sinonasal cavernous hemangioma
from: First Author: Krisnamurti Sarmento Junior (Sarmento, KJ) Co-authors: Joao Daniel Caliman Gurgel (gurgel, JDC) Klinger Wagner T.da Costa (costa,KWT) Eugenio Mello (mello,E)Hemangiomas are benign endothelial lesions classified as
capillary, cavernous or mixed, according to the predominant vascular channels.
Cavernous hemangiomas are rare in the sinonasal cavity and traditionally
approached externally. We report a case of an 18-years old man with a cavernous
hemangioma occupying the ethimoid and maxillary sinuses, presenting with
unilateral nasal obstruction and recurrent sinusitis. The tumor was completely
removed endoscopically and there were no signs of recurrence after 18 months
follow-up. This is only the second report to date of a cavernous hemangioma of
the sinonasal cavity resected endoscopically and the first one to accomplish an
en bloc resection.
Hemangiomas are benign endothelial lesions that are rare in
the nose and even rarer in the paransal sinus. They are classified
histologically as capillary, cavernous or mixed, according to the predominan
vascular channels within the tumor. Most hemangiomas in the nose are small
capillary lesions that arise from the nasal septum or vestibule. Only few
originate from the lateral wall of the nose with a predominance of cavernous hemangioma,
which tends to be larger and more aggressive.
Cavernous hemangioma may present as a unilateral mass
occupying the sinuses and the nose causing epistaxis, progressive nasal
obstruction, recurrent sinusitis and very often proptosis and diplopia due to
invasion of the orbit. Biopsies may be problematic because of lesion site and
risk of uncontrollable bleeding.
Hemangiomas of nose and paransal sinus have usually
been approached externally, but the advances in endoscopic surgery are
constantly broadening its indications.
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