Sinonasal intravascular papillary endothelial hyperplasia successfully treated by endoscopic excision: A case report and review of the literature

Abstract Background Intravascular papillary endothelial hyperplasia (IPEH) is an abundant, usually intravascular, benign endothelial proliferation that may mimic angiosarcoma clinically and histopathologically. Its occurrence in the sinonasal cavity is extremely rare. To the best of our knowledge, w...

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Published in:Auris, nasus, larynx nasus, larynx, 2009-06, Vol.36 (3), p.363-366
Main Authors: Wang, Zhen-Hong, Hsin, Chung-Han, Chen, Shiou-Yi, Lo, Cheng-Yu, Cheng, Po-Wen
Format: Article
Language:English
Subjects:
Adult
Angiosarcoma
Cerebrospinal Fluid Rhinorrhea - complications
Endoscopy
Endoscopy - methods
Endothelium
Endothelium, Vascular - pathology
Endothelium, Vascular - surgery
Epistaxis - etiology
Ethmoid Sinus - blood supply
Ethmoid Sinus - pathology
Ethmoid Sinus - surgery
Headache - etiology
Hemangiosarcoma - pathology
Hemangiosarcoma - surgery
Humans
Hyperplasia
Hyperplasia - complications
Hyperplasia - pathology
Hyperplasia - surgery
Magnetic Resonance Imaging
Male
Nasal Cavity - pathology
Nasal Cavity - surgery
Nasal Obstruction - diagnosis
Nasal Obstruction - etiology
Otolaryngology
Paranasal Sinus Neoplasms - pathology
Paranasal Sinus Neoplasms - surgery
Sinonasal cavity
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Summary:Abstract Background Intravascular papillary endothelial hyperplasia (IPEH) is an abundant, usually intravascular, benign endothelial proliferation that may mimic angiosarcoma clinically and histopathologically. Its occurrence in the sinonasal cavity is extremely rare. To the best of our knowledge, we present the first case with the most extensive IPEH ever found within the sinonasal cavity. Methods A 42-year-old man of intravascular papillary endothelial hyperplasia in the sinonasal cavity was reported. He complained of a 1-year history of left-sided nasal obstruction accompanied by unilateral rhinorrhea, repeated epistaxes and frontal headache. Anterior rhinoscopy demonstrated a smooth-surfaced reddish mass occupying the left nasal cavity. Endoscopic surgery was used to clear this uncommon tumor in the sinonasal cavity. A review of the pertinent literature was also presented. Conclusions IPEH may be mistaken for an angiosarcoma clinically and histopathologically. Complete endoscope-guided surgical excision is the best choice of therapy for patients with IPEH and is both diagnostic and curative. Awareness of this lesion will prevent incorrect diagnosis and overly aggressive treatment.
ISSN:0385-8146
1879-1476
DOI:10.1016/j.anl.2008.06.006