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Hemangioma of the Nasal Septum in a Middle Aged Female

Author(s): Muhammad Wasi Ahmed, Lamya H Almaghrabi, Waleed M Alshehri, Najd A Aldriweesh, Sara G Al Mutari

Introduction: Hemangioma is a benign, rapidly growing solitary lesion, occur in the skin and mucous membrane. Etiology of such a lesion is unknown, but it could be due to trauma and hormonal factors. According to several reports, a common site of such a lesion is oral cavity. Rarely, it involves the nasal cavity. Symptoms caused by such a lesion are bleeding and nasal obstruction.

Presentation of case: A 44-year-old female presented with progressive right-sided nasal obstruction and off and on epistaxis. Examination of nasal cavity physically combined with endoscopic examination revealed a large, reddish color mass in the nasal cavity on the right side. CT scan of the nose and paranasal sinuses also showed a soft-tissue mass originating from the anterior part of the nasal septum. (CT scan was asked to rule out the possibility of bony erosion that can be found at the base of the lesion and also hemangiomas capture the contrast in the bright lobular region.) Complete excision carried out along, with attached nasal septal mucosa and perichondrium under general anesthesia. Preoperative embolization or perioperative transfusion was not required. The histopathology reported as a benign vascular proliferative lesion, consistent with lobular capillary hemangioma. The patient’s recovery was uneventful. Patient attended regular OPD follow up for more than six months. During this period no recurrence of the lesion seen and finally the patient discharged from OPD.

Discussion: Use of MRI as an investigation tool is indicated especially if the lesion is extremely large and originate from nasal roof in order to rule out any intracranial relation. Excision of lesion confined to the anterior nasal septum is recommended endoscopically as there is no need of preoperative embolization or perioperative blood transfusion.

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