Nayani Divya, Pitale Ashok Rahul Kumar, Loka Sudarshan Reddy, Jacob Anju Susan, Maley Sai
Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No 5-1-174, Opposite State Bank of India Head Office, Bank Street Road, Koti, Hyderabad, 500095 India.
NRG Oncology/Hillman Cancer Center, NSABP Foundation, Inc., 1307 Federal St, Suite 303, Pittsburgh, PA 15212 USA.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3369-3373. doi: 10.1007/s12070-024-04692-x. Epub 2024 Apr 29.
Hemangiopericytoma is a rare vascular neoplasm derived from pericytes, with uncertain malignant potential. It mainly occurs in the retroperitoneum and lower extremities, with a lower incidence in the head and neck region and nasal cavity. Diagnosis is aided by histopathological examination and immunohistochemistry. Surgical excision is the preferred treatment, with different approaches depending on tumour size. Endoscopic excision is suitable for small tumours, while larger ones may require external approaches. The recurrence rate is approximately 25%, emphasizing the importance of long-term follow-up. Our study aims to discuss a rare series of sinonasal hemangiopericytoma cases, their clinical presentation, and their management. In this study, we are discussing the prospective study of six cases of sinonasal hemangiopericytoma that were presented to a tertiary hospital, from June 2017 to June 2023, with complaints of nasal obstruction and bleeding episodes. They were assessed with a detailed history, blood investigations, radiological investigations, and diagnostic nasal examination, and underwent endoscopic surgical excision of the nasal mass, with the diagnosis confirmed by histopathological examination and immunohistochemistry. All cases were followed up for 1 year postoperatively, except one case which missed follow-up after 6 months and with no postoperative complications and recurrences. All six cases came with complaints of nasal obstruction and bleeding from the nasal cavity. All six cases underwent endoscopic surgical excision of the tumour and were followed for 1 year in five cases; one case missed follow-up after 6 months of postoperative follow-up, but no recurrence was noted in all the cases. For small-sized hemangiopericytoma tumours, endoscopic excision offers benefits such as improved visualization, easy resection, preservation of the normal anatomical structure, and maintenance of physiological function in the sinonasal cavities. With a recurrence rate of approximately 25%, surgical excision and long-term follow-up play essential roles in successful tumour management.
血管外皮细胞瘤是一种罕见的源自周细胞的血管肿瘤，其恶性潜能不确定。它主要发生于腹膜后和下肢，在头颈部区域和鼻腔的发病率较低。组织病理学检查和免疫组织化学有助于诊断。手术切除是首选治疗方法，根据肿瘤大小采用不同的手术方式。内镜切除适用于小肿瘤，而较大的肿瘤可能需要采用外部手术方式。复发率约为25%，这凸显了长期随访的重要性。我们的研究旨在探讨一系列罕见的鼻窦血管外皮细胞瘤病例、它们的临床表现及治疗方法。在本研究中，我们讨论了2017年6月至2023年6月期间在一家三级医院就诊的6例鼻窦血管外皮细胞瘤的前瞻性研究，这些患者均有鼻塞和鼻出血症状。他们接受了详细的病史询问、血液检查、影像学检查和诊断性鼻内镜检查，并接受了鼻腔肿物的内镜手术切除，组织病理学检查和免疫组织化学确诊。所有病例术后均随访1年，除1例在术后6个月失访外，均无术后并发症及复发。所有6例患者均有鼻塞和鼻腔出血症状。所有6例均接受了肿瘤的内镜手术切除，5例随访1年；1例术后6个月失访，但所有病例均未复发。对于小尺寸的血管外皮细胞瘤肿瘤，内镜切除具有视野清晰、切除容易、保留正常解剖结构以及维持鼻窦生理功能等优点。复发率约为25%，手术切除和长期随访在肿瘤的成功治疗中起着至关重要的作用。
