Kuznecov M.S., Voronov A.V., Savello A.V., Dvorjanchikov V.V., Kireev P.V. Diagnosis and treatment of epitelioid hemangioedothelioma of synonasal localization: clinical case. Head and neck Russian Journal. 2020;8(2):59–64 (in Russian).
DOI: https://doi.org/10.25792/HN.2020.8.2.59-64
Introduction. Epithelioid hemangioendothelioma is a rare vascular endothelial tumor, of low malignancy, which affects adults of all age groups and is mostly often localized in soft tissues, liver, lungs and bones. There is а few number of publications about this tumor lesion in the nasal cavity and paranasal sinuses. The rarity of this tumor, unusual anatomical location and nonspecific symptoms create problems for diagnosis and treatment. Immunohistochemical and moleculargenetic research methods play a major role in the diagnosis. Treatment consists of radical surgical removal of the tumor and follow-up to control relapse
Clinical case. Рatient of 60 years was troubled by complaints of nosebleeds, difficulty in nasal breathing for 6 months. According to the results of endoscopic examination, contrast-enhanced CT and MRI examinations, and endovascular angiography, a well-vascularized tumor of sinonasal localization with dimensions of 65×60×47 mm was detected, causing bone destruction of the walls of the maxillary sinuses, the ethmoid bone, the medial wall of the left orbit with penetration into it, left pterygopalatine and infratemporal fossae. After embolization of the tumor vessels, endonasal endoscopic resection of the tumor was performed under the control of electromagnetic navigation station using rhinosurgical instruments, laser technology. After histological and immunohistochemical analysis, the diagnosis of epithelial hemangioendoteoioma was confirmed. In control MRI examination, tumor tissue is not determined.
Conclusion. Endonasal endoscopic resection of epithelioid hemangioendothelioma of synonasal localization is the method of choice in the treatment of this tumor. It is necessary to use immunohistochemical and molecular-genetic methods of research in diagnosis of the disease.
Key words: endoscopic rhinosurgery, epithelial hemangioendothelioma, laser, electromagnetic navigation
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study.
For citation: Kuznecov M.S., Voronov A.V., Savello A.V., Dvorjanchikov V.V., Kireev P.V. Diagnosis and treatment of epitelioid hemangioedothelioma of synonasal localization: clinical case. Head and neck Russian Journal. 2020;8(2):59–64 (in Russian).
The authors are responsible for the originality of the data presented and the possibility of publishing illustrative material – tables, figures, photographs of patients.