Capillary Hemangioma of Nose & Sinus

Case 1: Capillary Hemangioma

A 75 year old female was seen with a history of left-sided nasal obstruction with on and off intermittent episodes of epistaxis. CT scan of the paranasal sinuses showed progressively enhancing soft-tissue density or mass occupying entire left nasal cavity causing deviated nasal septum to right side. Diagnostic nasal endoscopy showed a grayish white mass in the left nasal cavity. The external surface was covered by a hemorrhagic crust. The mass was removed by endoscopic approach and was sent for histopathology examination. Histopathology described thickened epithelial covering of squamous type with multiple irregular papillary folds lined by multilayered epithelium that was regular and with uniform nuclei with fibrovascular core infiltrating deeply into the fibro myxoid connective tissue stroma.

View of Nasal Polyp - Capillary Hemangioma

Figure 2: CT Scan of Capillary Hemangioma

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Figure 1: View of Capillary Hemangioma Filling the Left Nasal Cavity Click on Pictures to Enlarge

Figure 2: CT Scan of Capillary Hemangioma

The pathologist at our institute reported it as an angiofibroma.
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View Surgery Video - FLASH View Surgery Video - MPEG 4 (I Pad)

But considering the rarity of the extra nasopharyngeal angiofibroma in females, we decided to seek a second opinion and to differentiate between capillary hemangioma and nasopharyngeal angiofibroma. A special stain with CD 31 and CD 34 was set up that revealed its true nature as a capillary hemangioma. Click on Pictures to Enlarge