IMMUNOHISTOCHEMISTRY IN DIAGNOSIS OF EXTRANASOPHARYNGEAL ANGIOFIBROMA ORIGINATING FROM NASAL CAVITY: CASE PRESENTATION AND REVIEW OF THE LITERATURE

Angiofibromas are rare vascular tumors which originate predominantly in the nasopharynx and occur typically in male adolescents. Extranasopharyngeal sites such as nasal cavity and paranasal sinuses are less frequent. This review article was undertaken to evaluate the incidence, clinical features and management of extranasopharyngeal angiofibromas originating exclusivelly from nasal cavity structures. Our focus of interest was to evaluate the significance of immunohistochemical analysis in diagnosis of such extremely rare neoplasms. In the PubMed and Google Search, we found only 39 cases of nasal angifibroma, 27 males and 12 females from 1980 to 2012. The most prevalent site of origin was nasal septum, followed by inferior and middle turbinate. The commonest symptoms were nasal obstruction and epistaxis. Nasal angiofibromas are clinically distinct from nasopharyneal angiofibromas and can therefore be misdiagnosed. The differential diagnosis includes other vascular lesions, such as lobular capillary hemangioma and sinonasal-type hemangiopericytoma. Although immunohistochemistry is not necessary for differentiation between angiofibroma and capillary hemangioma, that diagnostic procedure may be helpful in distinction from sinonasal hemangiopericytoma. As an ilustration for immunohistochemical analysis, we presented a case of an elderly woman with tumor arising from the middle turbinate, diagnosed as angiofibroma. The staining was positive for CD34, CD31, factor VIII, vimentin and smooth muscle α-actin, and negative for desmin.

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Middle turbinate angiofibroma in an elderly woman

Vojnosanitetski pregled ◽

10.2298/vsp0907583p ◽

2009 ◽

Vol 66 (7) ◽

pp. 583-586 ◽

Cited By ~ 11

Author(s):

Aleksandar Peric ◽

Nenad Baletic ◽

Snezana Cerovic ◽

Biserka Vukomanovic-Djurdjevic

Keyword(s):

Nasal Cavity ◽

Elderly Woman ◽

Anterior Part ◽

Middle Turbinate ◽

Immunohistochemical Analysis ◽

Vascular Tumors ◽

Male Adolescents ◽

Sphenopalatine Foramen ◽

First Case ◽

Left Middle

Background. Angiofibromas are histologically benign vascular tumors, originating from the nasopharynx, near by the area of sphenopalatine foramen. These neoplasms occur typically in male adolescents. Reports of primary extranasopharyngeal angiofibromas have appeared sporadically in the literature in English. We present the first case of an elderly woman with tumor arising from the middle turbinate, diagnosed as angiofibroma. Case report. A 63-year-old female presented with left-sided nasal obstruction and epistaxis. Endoscopic evaluation revealed a polypoid mass arising from the anteroinferior portion of the left middle turbinate. Computed tomography (CT) scan showed a soft-tissue opacity that filled the anterior part of the left nasal cavity. After the endoscopic excision of the mass, postoperative pathohistological and immunohistochemical analysis confirmed the diagnosis of an angiofibroma. Two years later, the patient was free of symptoms and without endoscopic evidence of recurrence. Conclusion. Extranasopharyngeal angiofibromas arising from the nasal cavity are extremely rare tumors. Immunohistochemical analysis is very important in all doubtful cases, especially in those with atypical location.

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Spindle Cell Hemangioma of the Nasal Cavity: A Rare Tumor with Unusual Presentation

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1177 ◽

2013 ◽

Vol 6 (3) ◽

pp. 149-151

Author(s):

RS Mudhol ◽

Vijayalaxmi Suranagi ◽

Anil S Harugop ◽

Hema B Bannur ◽

Ganga S Pilli

Keyword(s):

Nasal Cavity ◽

Spindle Cell ◽

Polypoid Lesion ◽

Middle Turbinate ◽

Capillary Hemangioma ◽

Unusual Presentation ◽

Vascular Tumors ◽

Recurrent Bleeding ◽

Rare Tumor ◽

Spindle Cell Hemangioma

ABSTRACT Vascular tumors as such are rare in the nasal cavity. Few cases of lobular capillary hemangioma, cavernous hemangioma and epitheloid hemangioendothelioma have been reported in the nasal cavity. But, there are no reports of spindle cell hemangioma occurring within the nasal cavity. They usually present as subcutaneous nodules in the extremities. A case of recurrent bleeding polypoid lesion in the left nasal cavity, arising from the middle turbinate which showed features of spindle cell hemangioma is reported for its rarity and unusual presentation. The tumor was excised by minimally invasive transnasal endoscopic approach. How to cite this article Suranagi V, Harugop AS, Bannur HB, Pilli GS, Mudhol RS. Spindle Cell Hemangioma of the Nasal Cavity: A Rare Tumor with Unusual Presentation. Clin Rhinol An Int J 2013;6(3):149-151.

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A rare case of pediatric intranasal lobular capillary hemangioma

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204641 ◽

2020 ◽

Vol 6 (11) ◽

pp. 2115

Author(s):

Sam D. Schild ◽

Rachel Irizarry ◽

Ann Plum

Keyword(s):

Nasal Cavity ◽

Surgical Excision ◽

Vascular Lesion ◽

Capillary Hemangioma ◽

Vascular Tumors ◽

Preoperative Embolization ◽

Mri Imaging ◽

En Bloc ◽

Lobular Capillary Hemangioma ◽

The Right

<p class="abstract">Pediatric nasal cavity vascular tumors express a wide variety of pathologies. Lobular capillary hemangioma (LCH) is an acquired benign vascular growth of skin and mucosa whose etiology remains unknown, though trauma and hormonal influences are implicated. Although well documented in the head and neck literature for children age five or less, it is a rarity within the nasal cavity and has yet to be documented in the mid-septum. We describe a unique case of intranasal LCH and review the current literature. A nine-year-old male presented with one week of profuse intermittent unilateral epistaxis and no history of nasal trauma. Rhinoscopy revealed a pink, pedunculated mass of the right mid-nasal septum at the bony-cartilaginous junction. CT and MRI imaging were consistent with an expansile vascular lesion receiving prominent bilateral sphenopalatine artery supply. Following embolization, en bloc endoscopic surgical excision of the lesion using cold dissection was performed with no bony or cartilaginous involvement noted. The epistaxis resolved following resection. Final histology confirmed the mass as a lobular capillary hemangioma. Paediatric intranasal LCH is a rare entity, yet warrants consideration in our differential diagnosis of pediatric vascular tumors. Our study indicates these lesions can develop in the mid-septum despite the absence of a vascular plexus. Preoperative embolization should be considered for pediatric nasal cavity tumors due to concern for hemorrhage. Endoscopic wide local excision is an appropriate and effective treatment. </p>

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Intranasal Lobular Capillary Hemangioma with Multiple Sites of Origin during Pregnancy: A Case Report and Literature Review

Case Reports in Otolaryngology ◽

10.1155/2018/7413918 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Lama S. Alalula ◽

Abdullah S. Arafat ◽

Riyadh A. Alhedaithy ◽

Mohammed Elkrim

Keyword(s):

Case Report ◽

Nasal Cavity ◽

Symptomatic Relief ◽

Middle Turbinate ◽

Posterior Part ◽

Capillary Hemangioma ◽

Surgical Removal ◽

En Bloc ◽

Lobular Capillary Hemangioma ◽

Recurrent Epistaxis

In the present case report, we describe a 33-year-old pregnant woman in the third trimester with a history of recurrent epistaxis leading to frequent visits to the emergency department. Each episode of epistaxis was managed by anterior nasal packing. During endoscopic examination, a left nasal mass was seen. She was admitted and managed conservatively until she delivered her baby without complication. After delivery, a CT scan was taken, which showed an enhancing mass in the middle and lower meatus of the nasal cavity with no bony erosions. For symptomatic relief and tissue diagnosis, endoscopic surgical removal was advised. An intraoperative examination revealed a red, smooth, and well-circumscribed mass occupying the left nasal cavity and originating from the medial surface of the inferior turbinate and the inferior surface of the posterior part of the middle turbinate. A complete en bloc resection of the mass was performed endoscopically. The mass was sent for histologic analysis, which confirmed the diagnosis of lobular capillary hemangioma. Eventually, upon follow-up at two weeks, one month, three months, and six months postsurgery, no evidence of recurrence was detected.

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Lobular Capillary Hemangioma of Nasal Cavity

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1098 ◽

2011 ◽

Vol 4 (3) ◽

pp. 152-153

Author(s):

Vaneeta Bhardwar ◽

Kulbir Kaur ◽

Sonia Arora

Keyword(s):

Nasal Cavity ◽

Nasal Obstruction ◽

Benign Lesion ◽

Middle Turbinate ◽

Capillary Hemangioma ◽

Diagnosis And Treatment ◽

Unknown Etiology ◽

Lobular Capillary Hemangioma

ABSTRACT Nasal lobular capillary hemangioma is a benign lesion of unknown etiology. Epistaxis and nasal obstruction are the most marked symptoms. We present a case of lobular capillary hemangioma, which was located on the posterior end of middle turbinate. The case is reported for its potential for being misdiagnosed and to highlight the advantage of nasal endoscopes in diagnosis and treatment.

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Pediatric Lobular Capillary Hemangioma Nasal Cavity

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1238 ◽

2015 ◽

Vol 8 (2) ◽

pp. 76-80

Author(s):

Saurabh Varshney ◽

Priyanka Gairola ◽

Manu Malhotra

Keyword(s):

Nasal Cavity ◽

Inferior Turbinate ◽

Capillary Hemangioma ◽

Vascular Lesions ◽

Unknown Etiology ◽

Radiological Findings ◽

Lobular Capillary Hemangioma ◽

Rare Location ◽

Histopathological Results

ABSTRACT A lobular capillary hemangioma (LCH) is a benign uncommon entity of unknown etiology among vascular lesions of the head and neck. Although it has no predilection for age, it is more common in the third decade and in females. Lobular capillary hemangioma usually involves the gingiva, lips, tongue and buccal mucosa. The nasal cavity is a rare location. The most common symptoms are nasal obstruction and epistaxis. The treatment is nasal endoscopic surgery. We review these vascular lesions and present the clinical features, radiological findings, treatment performed and histopathological results of two cases of LCH originating in the left inferior turbinate and septum. No recurrence was observed after complete endoscopic resection during 6 months follow-up. Lobular capillary hemangioma should be taken into consideration among the differential diagnosis of a painless hemorrhagic endonasal mass even though it is a rare entity. If complete resection is performed, prognosis is excellent and the recurrence rate is low. How to cite this article Varshney S, Malhotra M, Kaur N, Gairola P. Pediatric Lobular Capillary Hemangioma Nasal Cavity. Clin Rhinol An Int J 2015;8(2):76-80.

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CT Features of Lobular Capillary Hemangioma of the Nasal Cavity

American Journal of Neuroradiology ◽

10.3174/ajnr.a1908 ◽

2009 ◽

Vol 31 (4) ◽

pp. 749-754 ◽

Cited By ~ 32

Author(s):

D.G. Lee ◽

S.K. Lee ◽

H.W. Chang ◽

J.Y. Kim ◽

H.J. Lee ◽

...

Keyword(s):

Nasal Cavity ◽

Capillary Hemangioma ◽

Lobular Capillary Hemangioma ◽

Ct Features

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Pyogenic Granuloma: A Case Report

Health Renaissance ◽

10.3126/hren.v8i3.4215 ◽

1970 ◽

Vol 8 (3) ◽

pp. 196-198 ◽

Cited By ~ 1

Author(s):

Md T Rizwanulla ◽

Bandana Koirala ◽

Shivalal Sharma ◽

Lalita Adhikari ◽

Anju Pradhan

Keyword(s):

Case Report ◽

Inflammatory Response ◽

Pyogenic Granuloma ◽

Capillary Hemangioma ◽

Definitive Diagnosis ◽

Vascular Lesions ◽

Minor Trauma ◽

Lobular Capillary Hemangioma ◽

Dental Restorations ◽

Foreign Materials

Anju Pradhan was added as an author of this paper on 04/03/2011Pyogenic granulomas (PG) are common benign vascular lesions of the skin and mucosa. They are neither infective, purulent nor granulomatous as the name might suggest-rather a reactive enlargement that is an inflammatory response to local irritation such as calculus, fractured tooth, minor trauma, rough dental restorations and foreign materials. Here, we report a case of 13 year old patient with PG and in addition to the knowledge, the importance of biopsy findings in establishing definitive diagnosis has been emphasized. Keywords: pyogenic granuloma; inflammatory hyperplasia; lobular capillary hemangioma. DOI: 10.3126/hren.v8i3.4215Health Renaissance, September-December 2010; Vol 8 (No.3);196-198

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