A Rare Case of Cavernous Hemangioma of Maxillary Sinus

Abstract

A 9 years old girl, presented with longstanding, left sided nasal obstruction and serosanguinous nasal discharge. She had been experiencing nasal obstruction and intermittent epistaxis for one year already. Her past medical history was otherwise unremarkable. The patient on anterior rhinoscopy, a bulge was detected, arising from the left nasal wall and impinging on the septum. The computed tomography (CT) examination was performed on a spiral scanner. The CT scan obtained following intravenous contrast administration revealed a large, inhomogeneously enhancing mass in the left maxillary sinus and nasal cavity (Figure 1,2&3). The nasal turbinates and the medial wall of the maxillary sinus had been eroded by the mass. There was also a bony remodeling in the anterior wall of the maxillary sinus. Because of the suspicion of sinonasal cancer, a biopsy was taken to obtain tissue from the nasal cavity and maxillary sinus. However, the biopsy revealed multiple submucosal dilated vessels filled with blood, fibrin deposition and organized thrombi stain for fungal organism negative, findings consistent with hemangioma. The microscopic examination showed dilated sinusoidal vascular channels in the stroma lining with an interconnecting fibrous wall covered with flat endothelium. The Lumina of these spaces were filled with blood. The histologic features were most compatible with cavernous hemangioma (Figure 4). On follow up, patient improvement regarding nasal obstruction and less nasal bleeding.