Pediatric Nasal Lobular Capillary Hemangioma

Jordan M Virbalas,Sanjay R Parikh,John P Bent

doi:10.1155/2012/769630

Abstract

Background. LCH is a benign vascular growth of the skin and mucous membranes commonly affecting the head and neck. Since it was first described in the nineteenth century, this entity has been variously known as “human botryomycosis” and “pyogenic granuloma.” The shifting nomenclature reflects an evolving understanding of the underlying pathogenesis. We review the histopathology of and current epidemiological data pertaining to LCH which suggests that the development of these lesions may involve a hyperactive inflammatory response influenced by endocrine factors. We report two new cases of pediatric lobular capillary hemangioma (LCH) of the nasal cavity and review current theories regarding the etiology, diagnosis, and treatment of nasal LCH. Methods. Retrospective case series. Case Series. Two adolescent females presented with symptoms of recurrent epistaxis, nasal obstruction, and epiphora. Both patients underwent computed tomography imaging and biopsy of their intranasal mass. The tumors were excised using image-guided transnasal endoscopic technique. Seven other cases of nasal LCH have been reported to date in the pediatric population. Conclusion. Nasal LCH is a rare cause of an intranasal mass and is associated with unilateral epistaxis, nasal obstruction, and epiphora. We advocate for image-guided endoscopic excision of LCH in the adolescent population.

Highlights

Lobular capillary hemangioma (LCH) is a benign vascular growth of the skin and mucous membranes commonly affecting the head and neck [1, 2]
The authors referred to this condition as “human botryomycosis,” speculating that the lesions were secondary to a fungal infection thought to cause morphologically similar lesions in horses
In 1904, Hartzell coined the term “pyogenic granuloma” to describe these lesions which he presumed to be granulation tissue arising in response to a bacterial infection [4]

Summary

Background

LCH is a benign vascular growth of the skin and mucous membranes commonly affecting the head and neck. Since it was first described in the nineteenth century, this entity has been variously known as “human botryomycosis” and “pyogenic granuloma.”. Two adolescent females presented with symptoms of recurrent epistaxis, nasal obstruction, and epiphora. Both patients underwent computed tomography imaging and biopsy of their intranasal mass. Seven other cases of nasal LCH have been reported to date in the pediatric population. We advocate for image-guided endoscopic excision of LCH in the adolescent population

Introduction

Description of Case Series

Findings

Discussion