Sinonasal hemangiopericytoma: Report of two cases and review of literature

Abstract

IntroductionHemangiopericytoma is a low grade malignant vascular tumor. It is rare and is characterised by a poorly clinical presentation and often confused with other fibrous tumor, which could poses difficulties on diagnosis. The nasal cavity is an uncommon site and have a distinct behaviour compared to others location.Case presentationWe report the case of two women who consulted for epistaxis and nasal obstruction. Vascular masses were visualized with nasal endoscopy – one in the left nasal cavity and the second one had a destructive mass of the right hemiface. CT scan and MRI helped identifying the mass, its margins and its extirpability. The Diagnosis was confirmed by histology examination. In one patient, surgery was performed. The second patient had an aggressive and invading tumor for which chemotherapy was performed. The first patient remained free of disease after surgery for a follow-up of 3 years, the second one had a fatal evolution.DiscussionSurgical treatment is the important mainstay, and it still controversial regarding wetherwhether the endonasal surgery could control tumor resection despite the wide performance, nowadays, of endoscopic techniques is still controversial. The use of embolization before surgical removal in place of chemotherapy is still unclear. We report our experience through two cases.ConclusionThe high rate of recurrence of this tumor requires a long follow-up after the most radical surgery possible. The external way must be adopted easily in front of any doubt of complete removal by endoscopy. Endoscopic techniques were regarded as appropriate for small low-vascularized tumors only.