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06 September 2022 : Case report  Brazil

[In Press] A Rare Case of Giant Cavernous Hemangioma of the Maxillary Sinus

Challenging differential diagnosis, Rare disease

Lucas Alves Teixeira Oliveira12ABCDEF, Rhayane PatrĂ­cia Rodrigues Oliveira1BEF, Laura Cardoso Vasconcelos3BCD, Achilles Alves de Levy Machado4CD, Gustavo Lara Rezende1ABDEG, Fayez Bahmad Jr.2ADG

DOI: 10.12659/AJCR.937191

Am J Case Rep In Press; DOI: 10.12659/AJCR.937191  

Available online: 2022-09-06, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
Hemangiomas are commonly located in the head and neck and rarely in the paranasal sinuses. These are benign vascular lesions, but with an increased risk of bleeding. The surgical approach must have detailed prior planning, given the increased risk of intraoperative bleeding. We herein describe the case of a 32-year-old male patient with recurrent epistaxis, nasal obstruction, and facial deformity due to a giant cavernous hemangioma successfully treated by endoscopic sinus surgery.
CASE REPORT
A 32-year-old man had nasal obstruction and intermittent epistaxis for 2 months. Physical examination also revealed facial deformity with enlargement of the nasal base and bulging in the maxillary region on the right. A soft and friable lesion occupying the entire right nasal cavity without bone erosion was observed on computed tomography (CT scan). Before surgery, the patient underwent angiographic evaluation, with evidence of main irrigation of the lesion by the right maxillary artery, which was then embolized. The patient underwent endoscopic nasal surgery. He maintained postoperative follow-up for 18 months, without recurrence of the lesion. Anatomopathological examination confirmed a cavernous hemangioma.
CONCLUSIONS
Cavernous hemangioma is a benign lesion of the paranasal sinuses. Due to non-specific clinical and radiological findings, its preoperative diagnosis is always challenging. The high index of suspicion of the malignancy should only be discarded after complete anatomopathological evaluation. A correct diagnosis is essential to avoid facial anatomical remodeling while excluding the diagnosis of other malignant lesions.

Keywords: Hemangioma; Hemangioma, Cavernous; Nasal Surgical Procedures

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923