Endoscopic resection of sinonasal hemangiomas and hemangiopericytomas

ORL J Otorhinolaryngol Relat Spec. 2006;68(2):69-72. doi: 10.1159/000091092. Epub 2006 Jan 20.

Abstract

Introduction: Endoscopic resection of benign neoplasms, such as inverted papilloma, has been well described. There are limited case reports of endoscopic resection of benign vascular tumors, including hemangiomas, or those with low-grade malignant potential, such as hemangiopericytomas.

Methods: Retrospective review of sinonasal hemangiomas and hemangiopericytomas resected endoscopically at a single tertiary-care facility.

Results: Three hemangiomas and 3 hemangiopericytomas were resected endoscopically with no recurrences at a mean follow-up of 22 months. Four tumors involved the skull base; 2 of these underwent preoperative embolization. One patient had a CSF leak that occurred as the tumor was removed from the cribriform plate and that was successfully repaired intraoperatively. The average size of the tumors was 5.8 cm x 2.7 cm with all tumors at least 2.5 cm in greatest dimension by computed tomography or magnetic resonance imaging. The largest tumor was 12 cm in greatest dimension. An average of 8 intraoperative frozen section margins was taken around 5 tumors, with all margins of each tumor clear on final pathology. Patients included 4 males and 2 females with an average age of 47 years.

Conclusion: Large vascular neoplasms of the sinonasal cavity, such as hemangiomas and hemangiopericytomas, can be safely removed using endoscopic techniques. Although these patients have a limited follow-up, it is prudent to perform long-term endoscopic follow-up in order to detect recurrences regardless of resection technique.

MeSH terms

  • Endoscopy / methods*
  • Female
  • Hemangioma / surgery*
  • Hemangiopericytoma / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Paranasal Sinus Neoplasms / surgery*
  • Retrospective Studies
  • Skull Base Neoplasms / surgery
  • Treatment Outcome