Endonasal resection of a sinonasal hemangiopericytoma

Abstract

Aim

Hemangiopericytomas (HP) are rare perivascular neoplasms with variable biological behaviour. The prognosis, by histology alone, is difficult. The clinical course of disease and the localization of the tumour are of importance. Sinonasal HP is usually of low malignant potential. Currently, a less invasive, endonasal, approach is chosen for resection of such tumours. One case of sinonasal HP treated by endonasal surgery is presented.

Case

A 61-year old man presented with nasal obstruction and stated that he had undergone endonasal surgery elsewhere twice before for “nasal polyps”, 19 and eight years previously. Anterior rhinoscopy revealed a polypoid lesion in the right nasal cavity. CT showed a mass of the right ethmoidal and sphenoidal sinus with no sign of bone destruction. We performed an endonasal total resection of the tumour. The histological diagnosis was of sinonasal HP. There was no local or remote metastasis. Histological reports of the earlier surgeries were compared and identified the same tumour.

Conclusions

The presented case shows a long-term benign course of recurrent sinonasal HP following endonasal resection. After more invasive approaches, such as lateral rhinotomy, local recurrence has been reported to appear within comparable periods of time. If the tumour is of limited extension, without infiltration of neighbouring structures, it can be removed via an endonasal approach.