Cavernous hemangioma of the nasal cavity: mimicking as the inverted papilloma
Keywords:Cavernous hemangioma, CT and MRI, Histopathology, Inverted papilloma
Cavernous hemangioma of the nasal cavity is extremely rare with only case reports in the literature highlighting the imaging findings on CT and MRI. Haemangioma are benign vascular tumours, which originate in the skin, mucosa and deep structures such as bones, muscles and glands. Exact etiopathogenesis of the haemangioma is not known, although they are divided into two types depending on the dominant vessel size at microscopy, capillary and cavernous. When these neoplasms arise in the nasal cavity, they are predominantly capillary and are found to arise from the nasal septum and are more common in the children. On the other hand, Cavernous haemangiomas are more likely to be found on the lateral wall of the nasal cavity and are more commonly seen in elderly. Also, inverted pappiloma also more commonly arise from the lateral wall of the nasal cavity, from the middle turbinate and also has the same demographics as the cavernous hemangioma. So, the distinction between the two should be carefully made based on the imaging findings so as to give the appropriate treatment to the patient. We have presented a rare case cavernous haemangioma arising from the mucosa of the middle nasal meatus, in a 37-year-old male which is mimicking as an inverted pappiloma based on the imaging features; however on histopathology proved to be cavernous hemangioma and also on the multimodal imaging that helps in early diagnosis and advocating appropriate and timely treatment.
Iwata N, Hattori K, Nakagawa T, Tsujimura T. Hemangioma of the nasal cavity: a clinicopathologic study. Auris Nasus Larynx. 2002;29(4):335–9.
Osborn DA. Haemangiomas of the nose. J Laryngol Otol. 1959;73(3):174–9.
Batsakis JG, Rice DH. The pathology of head and neck tumors: vasoformative tumors, part 9A. Head Neck Surg. 1981;3(3):231–9.
Enzinger F WS. No Title. 2nd edition. Soft tissue tumor. 1998.
Webb CJ, Porter G, Spencer MG, Sissons GR. Cavernous haemangioma of the nasal bones: an alternative management option. J Laryngol Otol. 2000;114(4):287–9.
Fahmy FF, Back G, Smith CE, Hosni A. Osseous haemangioma of inferior turbinate. J Laryngol Otol. 2001;115(5):417–8.
Nakahira M, Kishimoto S, Miura T, Saito H. Intraosseous hemangioma of the vomer: a case report. Am J Rhinol.1997;11(6):473–7.
Graumüller S, Terpe H, Hingst V, Dommerich S, Pau HW. An intraosseous hemangioma in the perpendicular lamina of the ethmoid bone. HNO. 2003;51(2):142–5.
Engels T, Schörner W, Felix R, Witt H, Jahnke V. Cavernous hemangioma of the maxillary sinus. HNO. 1990;38(9):342–4.
Hoehn JG, Farrow GM, Devine KD, Masson JK. Invasive hemangioma of the head and neck. Am J Surg. 1970;120(4):495–500.
Pasquini E, Sciarretta V, Farneti G, Modugno GC, Ceroni AR. Inverted papilloma: report of 89 cases. Am J Otolaryngol.;25(3):178–85.
Jeon TY, Kim H-J, Chung S-K, Dhong H-J, Kim HY, Yim YJ, et al. Sinonasal inverted papilloma: value of convoluted cerebriform pattern on MR imaging. AJNR Am J Neuroradiol. 2008;29(8):1556–60.
Dillon WP, Som PM, Rosenau W. Hemangioma of the nasal vault: MR and CT features. Radiology. 1991;180(3):761–5.
Itoh K, Nishimura K, Togashi K, Fujisawa I, Nakano Y, Itoh H, et al. MR imaging of cavernous hemangioma of the face and neck. J Comput Assist Tomogr. 1986;10(5):831–5.
Liu JK, Burger PC, Harnsberger HR, Couldwell WT. Primary Intraosseous Skull Base Cavernous Hemangioma: Case Report. Skull Base. 2003;13(4):219–28.
Kim HJ, Kim JH, Hwang EG. Bone erosion caused by sinonasal cavernous hemangioma: CT findings in two patients. AJNR Am J Neuroradiol. 1995;16(5):1176–8.
Hayden RE, Luna M, Goepfert H. Hemangiomas of the sphenoid sinus. Otolaryngol Head Neck Surg. 1979;88(2):136–8.
Zou ZJ, Wu YT, Sun GX, Zhu XP, Meng XZ, He ZQ. Clinical application of angiography of oral and maxillofacial hemangiomas. Clinical analysis of seventy cases. Oral Surg Oral Med Oral Pathol. 1983;55(5):437–47.
Shimshak RR WD. J Can Assoc Radiol. 1976;(27):203–5.
Jungheim M, Chilla R. The monthly interesting case -case no. 64. Cavernous hemangioma. Laryngorhinootologie. 2004;83(10):665–8.