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

• 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
• ISSN: 0385-8146; 1879-1476
• DOI: 10.1016/j.anl.2008.06.006

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.