Cavernous hemangioma of rhinopharynx: our experience and review of literature

• Authors: Domenico Testa , Sergio Motta , Eva Aurora Massimilla , Domenico Tafuri , Domenico Tafuri , Daniela Russo , Anna Russo , Pasquale Gianluca Landolfo , Massimo Mesolella , Gaetano Motta
• Languages of publication: EN

Abstracts

EN

Hemangiomas are benign tumors originating in the vascular tissues of skin, mucosa, muscles, glands, and bones. Although these tumors are common lesions of the head and neck, they rarely occur in the nasal cavity and paranasal sinuses. Cavernous haemangioma of the lateral wall of the nasopharynx has not previously been reported. We examined the clinical, radiological and therapeutic management of cavernous haemangioma of nasopharynx starting from a clinical case of a 26-year-old woman with a history of recurrent and conspicuous epistaxis and leftsided nasal associated severe obstruction. Nasopharynx examination, by flexible endoscopy, showed a cystic mass borne by the left side wall of the nasopharynx, in contact with the soft palate, covered by intact and regular mucosa. Contrast-enhanced computed tomography (CT) scan, confirmed these findings and showed contextual lamellar calcifications and inhomogeneous enhancement. The nasal endoscopic approach (FESS), under general anesthesia, allowed removal of the mass, without complications, after careful hemostasis of arterial branches. It was possible to establish the precise site of origin of the tumor only during the surgical procedure. Histopathological study showed mucosa with extensive vascular proliferation, with framework of lacunar/cavernous haemangioma, also present at lamellar bone tissue level. An unusual site and an unspecific clinical appearance can make diagnosis and treatment of a cavernous hemangioma of the nasopharynx difficult. The nasal endoscopic technique proved to be reliable in terms of adequate exposure and visualization of the lesion, control of bleeding, and complete removal of the mass.

Keywords

EN

hemangioma; epistaxis; functional endoscopy sinus surgery (FESS)

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2014
• Volume: 10
• Issue: 1

Dates

published

1 - 1 - 2015

online

17 - 12 - 2015

received

24 - 10 - 2015

accepted

4 - 11 - 2015

Contributors

author

Domenico Testa

• Department of Anesthesiologic, Surgical and Emergency Sciences; Otolaryngology - Head and Neck Surgery Unit; Second University of Naples – Italy

author

Sergio Motta

• Department of Neuroscience Reproductive and Dentistry Sciences, Otholaryngology Unit; University of Naples “Federico II”, Naples - Italy

author

Eva Aurora Massimilla

• Department of Anesthesiologic, Surgical and Emergency Sciences; Otolaryngology - Head and Neck Surgery Unit; Second University of Naples, Italy

author

Domenico Tafuri

• Department of Sport Sciences and Wellness, University of Naples “Parthenope”, Naples, Italy

author

Domenico Tafuri

• Department of Sport Sciences and Wellness, University of Naples “Parthenope”, Naples, Italy

author

Daniela Russo

• Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples - Italy

author

Anna Russo

• Santa Maria delle Grazie Hospital, Pathology Unit, Pozzuoli, Naples, Italy

author

Pasquale Gianluca Landolfo

• Department of Anesthesiologic, Surgical and Emergency Sciences; Otolaryngology - Head and Neck Surgery Unit; Second University of Naples – Italy

author

Massimo Mesolella

• Department of Neuroscience Reproductive and Dentistry Sciences, Otholaryngology Unit; University of Naples “Federico II”, Naples - Italy

author

Gaetano Motta

• Department of Anesthesiologic, Surgical and Emergency Sciences; Otolaryngology - Head and Neck Surgery Unit; Second University of Naples – Italy

References

• [1] Takeda K, Takenaka Y, Hashimoto M. Intraosseous hemangioma of the inferior turbinate. Case Reports in Medicine 2010:3 pages. Article ID 409429.
• [2] Bakhos D, Lescanne E, Legeais M, Beutter P, Moriniere S. Cavernous Hemangioma of the nasal cavity. Ann Otolaryngol Chir Cervicofac. 2008;125(2):94-7.
• [3] Batsakis JG, Rice DH. The pathology of head and neck tumors: vasoformative tumors, part 9A. Head Neck Surg 1981;3:231-9.[Crossref]
• [4] Akiner MN, Akturk MT, Demirtas M, Atmis EO. Intraosseous Cavernous Hemangioma of Inferior Turbinate: A Rare Case Report. Case Report Otolaryngol. 2011: 431365.
• [5] Okoje VN, Alonge TO, Olusanya AA. Intra-tumoral ligation and the injection of sclerosant in the treatment of lingual cavernous haemangioma. Niger J Med. 2011;20(1):172-5.
• [6] Webb CG, Porter G, Sissons GRJ. Cavernous hemangioma of the nasal bones: an alternative management option. J Laryngol Otol 2000;114:287-9.[Crossref]
• [7] Fahmy FF, Back G, Smith CE, Hosni A. Osseous hemangioma of inferior turbinate. J Laryngol Otol 2001;115:417-8.[Crossref]
• [8] Caylakli F, Cağici AC, Hurcan C, Bal N, Kizilkilic O, Kiroglu F. Cavernous hemangioma of the middle turbinate: a case report. Ear Nose Throat J. 2008;87(7):391-3.
• [9] Nakahira M, Kishimoto S, MiuraT, Saito H. Intraosseous hemangioma of the vomer: a case report. Am J Rhinol 1997;11:473-7.[Crossref]
• [10] Graumuller S, Terpe H, Hingst V, Dommerich S, Pau HW. Intraossares Hamangiom der Lamina perpendicularis ossis ethmoidalis. HNO 2003;5:142-5.[Crossref]
• [11] Engels T, Schorner W, Felix R, Witt H, Jahnke V. Kavernoses Hamangiom des Sinus maxillaris. HNO 1990;38:342-4.
• [12] Gourin C, Donna JM, Burlington ET, Hosni A. Diagnosis quiz case 3. Arch Otolaryngol Head Neck Surg 2000; 126:902-7.
• [13] Liu L, Kakiuchi-Kiyota S, Arnold LL, Johansson SL, Wert D, Cohen SM. Pathogenesis of human hemangiosarcomas and hemangiomas. Hum Pathol. 2013;44(10):2302-11.[Crossref][WoS]
• [14] Berra-Romani R, Avelino-Cruz JE, Raqeeb A, Della Corte A, Cinelli M, Montagnani S et al. Ca2+-dependent nitric oxide release in the injured endothelium of excised rat aorta: a promising mechanism applying in vascular prosthetic devices in aging patients. BMC Surg 2013 Oct 8;13(Suppl 2):S40.[WoS]
• [15] Moccia F, Dragoni S, Cinelli M, Montagnani S, Amato B, Rosti V et al. How to utilize Ca2+ signals to rejuvenate the repairative phenotype of senescent endothelial progenitor cells in elderly patients affected by cardiovascular diseases: a useful therapeutic support of surgical approach? BMC Surg 2013 Oct 8;13(Suppl 2):S46.[WoS]
• [16] Moccia F, Lodola F, Dragoni S, Bonetti E, Bottino C, Guerra G et al. Ca2+ Signalling in Endothelial Progenitor Cells: A Novel Means to Improve Cell-Based Therapy and Impair Tumour Vascularisation. Curr Vasc Pharmacol 2014;12(1):87-105.[WoS][Crossref]
• [17] Dragoni S, Guerra G, Pla Af, Bertoni G, Rappa A, Poletto V, et al. A Functional Transient Receptor Potential Vanilloid 4 (Trpv4) Channel Is Epxressed In Human Endothelial Progenitor Cells. J Cell Physiol 2015;230(1):95-104.[Crossref]
• [18] Potenza DM, Guerra G, Avanzato D, Poletto V, Pareek S, Guido D et al. Hydrogen sulphide triggers VEGF-induced intracellular Ca2+ signals in human endothelial cells but not in their immature progenitors. Cell Calcium. 2014; 56(3):225-34.[WoS][Crossref]
• [19] Sanchez-Hernandez Y, Laforenza U, Bonetti E, Fontana J, Dragoni S, Russo M, Avelino-Cruz JE et al., Store-operated Ca2+ entry is expressed in human endothelial progenitor cells. Stem Cells Dev. 2010; 19(12):1967-81.[WoS][Crossref]
• [20] Ronco V, Potenza DM, Denti F, Vullo S, Gagliano G, Tognolina M, Guerra G, Pinton P, Genazzani AA, Mapelli L, Lim D, Moccia F. A novel Ca2+-mediated cross-talk between endoplasmic reticulum and acidic organelles: implications for NAADP-dependent Ca2+ signalling. Cell Calcium. 2015;57(2):89-100.[WoS][Crossref]
• [21] Moccia F, Dragoni S, Lodola F, Bonetti E, Bottino C, Guerra G, Laforenza U, Rosti V, Tanzi F. Store-dependent Ca2+ entry in endothelial progenitor cells as a perspective tool to enhance cell-based therapy and adverse tumour vascularisation. Curr Med Chem 2012;19(34):5802-18.[Crossref]
• [22] Dragoni S, Laforenza U, Bonetti E, Lodola F, Bottino C, Guerra G, Borghesi A, Stronati M, Rosti V, Tanzi F, and Moccia F. Canonical Transient Receptor Potential 3 channel triggers VEGF-induced intracellular ca2+ oscillations in endothelial progenitor cells isolated from umbilical cord blood. Stem Cells and Development 2013;22(19):2561-80.[Crossref]
• [23] Dragoni S, Laforenza U, Bonetti E, Lodola F, Bottino C, Berra- Romani R, Carlo Bongio G, Cinelli MP, Guerra G, Pedrazzoli P, Rosti V, Tanzi F, Moccia F. Vascular endothelial growth factor stimulates endothelial colony forming cells proliferation and tubulogenesis by inducing oscillations in intracellular Ca2+ concentration. Stem Cells. 2011;29(11):1898-907.[Crossref][WoS]
• [24] Lodola F, Laforenza U, Bonetti E, Lim D, Dragoni S, Bottino C, Ong HL, Guerra G, Ganini C, Massa M, Manzoni M, Ambudkar IS, Genazzani AA, Rosti V, Pedrazzoli P, Tanzi F, Moccia F, Porta C. Store-operated ca(2+) entry is remodelled and controls in vitro angiogenesis in endothelial progenitor cells isolated from tumoral patients. PLoS One 2012 7(9):e42541
• [25] Dragoni S, Laforenza U, Bonetti E, Reforgiato M, Poletto V, Lodola F, Bottino C, Guido D, Rappa A, Pareek S, Tomasello M, Guarrera MR, Cinelli MP, Aronica A, Guerra G, Barosi G, Tanzi F, Rosti V, Moccia F. Enhanced Expression of Stim, Orai, and TRPC Transcripts and Proteins in Endothelial Progenitor Cells Isolated from Patients with Primary Myelofibrosis. PLoS One 2014;9(3):e91099[WoS]
• [26] Berra-Romani R, Raqeeb A, Torres-Jacome J, Guzman-Silva A, Guerra G, Tanzi F, Moccia F. The mechanism of injury-induced intracellular calcium concentration oscillations in the endothelium of excised rat aorta. J Vasc Res. 2012;49(1):65-76.[Crossref][WoS]
• [27] Dragoni S, Turin I, Laforenza U, Potenza DM, Bottino C, Glasnov TN, Prestia M, Ferulli F, Saitta A, Mosca A, Guerra G, Rosti V, Luinetti O, Ganini C, Porta C, Pedrazzoli P, Tanzi F, Montagna D, Moccia F. Store-operated ca(2+) entry does not control proliferation in primary cultures of human metastatic renal cellular carcinoma. Biomed Res Int. 2014:739494.[WoS]
• [28] Archontaki M, Stamou AK, Hajiioannou JK, Kalomenopoulou M, Korkolis DP, Kyrmizakis DE. Cavernous haemangioma of the left nasal cavity. Acta Otorhinolaryngol Ital. 2008; 28(6): 309-311.
• [29] Amato B, Compagna R, Della Corte GA, Martino G, Bianco T, Coretti G, Rossi R, Braucci A, Aprea G, Zeppa P, Puzziello A, Terranova C. Peripheral blood mono-nuclear cells implantation in patients with peripheral arterial disease: a pilot study for clinical and biochemical outcome of neoangiogenesis. BMC Surg. 2012;12 Suppl 1:S1.[WoS]
• [30] Niccoli Asabella A, Di Palo A, Rubini D, Zeppa P, Notaristefano A, Rubini G. [Distribution of 18F-FDG in a patient with evolving abdominal aortic aneurysm].Recenti Prog Med. 2012;103(11):552-4.
• [31] Caranci F, Brunese L, Reginelli A, Napoli M, Fonio P, Briganti F. Neck neoplastic conditions in the emergency setting: role of multidetector computed tomography. Semin Ultrasound CT MR. 2012;33(5):443-8.[WoS][Crossref]
• [32] Lazar CC, Costentin B, Francois A, Marie JP, Dehesdin D. “Bleeding polyp” of the nasal septum: an uncommon lesion in adults. Ann Otol Rhinol Laryngol. 2004;113(8):652-4.
• [33] Hyung JK, Jung HK, Jae HK, Eui GH. Bone erosion caused by sinonasal cavernous hemangioma: CT finding in two patients. Am Soc Neuroradiol 1994;16:1176_/8.
• [34] Ash JE, Old JW. Hemangiomas of the nasal septum. Trans Am Acad Ophtalmol Otolaryngol 1950;54:350-6.
• [35] Testa D, Motta G, Galli V, Iovine R, Guerra G, Marenzi G, Testa B. Outcome assessment in patients with chronic obstructive rhinitis CO2 laser treated. Acta Otorhinolaryngol Ital. 2006;26(1):32-7.
• [36] Mesolella M, Galli V, Testa D. Inferior turbinate osteoma: A rare cause of nasal obstruction. Otolaryngol Head Neck Surg. 2005;133(6):989-91.[WoS][Crossref]
• [37] Testa B, Mesolella M, Squeglia C, Testa D, Motta G. Carbon dioxide laser turbinate surgery for chronic obstructive rhinitis. Lasers Surg Med. 2000;27(1):49-54.[Crossref]
• [38] Tafuri D, Testa D, Guerra G, Iovine R, Lamarca S, Galera F, Marmo M, Di Iorio C, Di Minno RM, Iengo M. Barotraumatic sinusitis in underwater sporting activity: Physiopathological and clinical evaluations. Med Sport 2006, 59, 3:335-341.

Identifiers

DOI

10.1515/med-2015-0089