Issue N# 4 - 2006
RHINOLOGY
Sinonasal hemangiopericytoma: A case report
Authors : F. Facon, M. Sanjuan, J. Paris, Ch. Van Haverbeke, P. Dessi (Marseille)
Ref. : Rev Laryngol Otol Rhinol. 2006;127,4:267-272.
Article published in french
Downloadable PDF document french
Summary :
Objective: To define clinical, histological and radiological features of sinonasal hemangiopericytoma (SNHPC) and to describe its therapeutic management. Patients and methods: A case of SNHPC (47 year old man) of the left nasal cavity underwent endoscopic sinus surgery at our institution. This case is reported and discussed with a review of the literature. Discussion: SNHPC is a low grade malignant vascular tumour. The intra-nasal location is very rare. This unusual tumour of the nasal cavity has a specific clinical behaviour and prognosis. Diagnosis is confirmed by histological studies with immunohistochemical methods. Vimentin and SMA markers are reported positive in 98% and 92% of cases, respectively. Work up includes MRI and CT scan in order to assess the tumour extent. Angiography is useful to assess the vascularization and preoperative embolization reduces the intra-operative bleeding of large tumours. The gold standard treatment is surgery and the aim is to perform a wide excision with tumour free margins. Surgery can be performed by endoscopic techniques in patients without extra-nasal extension. Radiotherapy is advised for cases of suspect or positive margins. Post-treatment follow up focuses on lifelong endoscopic surveillance. Metastases are rare but recurrences can occur many years postoperatively. The treatment of recurrence is also surgical.
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