Ledderose Georg J, Gellrich Donata, Holtmannspötter Markus, Leunig Andreas
Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilian University Munich, Marchioninistraße 15, 81377 Munich, Germany.
Case Rep Otolaryngol. 2013;2013:796713. doi: 10.1155/2013/796713. Epub 2013 May 2.
Objectives. Hemangiopericytoma is a rare tumor entity deriving from pericytes. Less than 5% of hemangiopericytoma occur in the nasal cavity and are characterised by a rather benign nature with low tendency of metastasis. However, as the recurrence rate in the literature ranges from 9.5% to 50%-depending on the length of followup-a radical surgical resection is considered as the gold-standard treatment. Only a few years ago, a wide external approach, usually via lateral rhinotomy or Caldwell-Luc, was performed. Endoscopic techniques were regarded as appropriate for small low-vascularised tumors only. Methods. We present the case of a 64-year-old patient with an extended sinonasal hemangiopericytoma, who was successfully treated by an endoscopic controlled endonasal tumor resection after embolisation with Onyx. Further, to support the new treatment option, we review the literature concerning all features of sinonasal hemangiopericytomas and their therapeutical management. Results/Conclusion. Onyx, which has not been described in the context of hemangiopericytoma yet, is a very effective embolic agent for a preoperative embolisation of sinonasal hemangiopericytoma allowing a safe endoscopic surgery.
目的。血管外皮细胞瘤是一种源自周细胞的罕见肿瘤实体。鼻腔内发生的血管外皮细胞瘤不到5%，其特点是性质较为良性，转移倾向低。然而，根据文献报道，复发率在9.5%至50%之间（取决于随访时间长短），根治性手术切除被视为金标准治疗方法。就在几年前，通常采用经鼻侧切开术或柯-陆氏手术等广泛的外部入路。内镜技术仅被认为适用于小型低血管化肿瘤。方法。我们报告一例64岁患有鼻窦血管外皮细胞瘤的患者，该患者在使用Onyx栓塞后通过内镜控制下的鼻内肿瘤切除术成功治愈。此外，为支持这种新的治疗选择，我们回顾了有关鼻窦血管外皮细胞瘤的所有特征及其治疗管理的文献。结果/结论。Onyx尚未在血管外皮细胞瘤的背景下被描述过，它是鼻窦血管外皮细胞瘤术前栓塞的一种非常有效的栓塞剂，可实现安全的内镜手术。
