J Rhinol.  2017 Nov;24(2):127-131. 10.18787/jr.2017.24.2.127.

A Case of 2-Month-Old Infant with Lobular Capillary Hemangioma

• Kang YS
• Kang Y
• Han DH

• KMID: 2398832
• DOI: http://doi.org/10.18787/jr.2017.24.2.127

Abstract

Lobular capillary hemangioma (LCH) in the nasal cavity, previously known as pyogenic granuloma, is an extremely rare benign vascular tumor in infants. LCH is a rapidly growing lesion that has a bleeding tendency due to its excessive vascularity. The authors experienced a case of LCH of the nasal cavity in a 2-month-old infant that was totally resected via the endoscopic approach after preoperative embolization. Therefore, we report this case with a brief review of the literature.

Keyword

Hemangioma; Hemangioma, lobular capillary; Embolization, therapeutic; Intranasal surgery

MeSH Terms

Embolization, Therapeutic
Granuloma, Pyogenic*
Hemangioma
Hemorrhage
Humans
Infant*
Nasal Cavity
Nasal Surgical Procedures

Figure

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  Fig. 1 Preoperative and postoperative photographs of the patient's face and left nasal cavity. No swelling or mass in the face (A), but left nasal cavity mass was detected (B). Protruding mass was observed after 1 month (C). The patient's postoperative 2-month follow-up photograph (D) and endoscopic image (E) shows no evidence of tumor recurrence.

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  Fig. 2 MRI reveals that 4×2.4 cm sized T1 low signal (A), T2 high signal (B), enhancing T1 axial (C) and coronal (D) mass in left nasal cavity.

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  Fig. 3 Preoperative CT [Axial (A) and coronal (B) image] shows increased size (5.2×3 cm) of well-defined heterogeneous enhancing mass in the left nasal cavity.

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  Fig. 4 Preoperative transfemoral cerebral angiogram (TFCA) and tumor embolization. The picture (A) is pre-procedure image which shows hypervascular lesion on the left nasal cavity. The picture (B) is the photo under the procedure which contrast media and embolization material is mixed and injected at the same time. The picture (C) is post-procedure image and shows devascularization of the tumor.

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  Fig. 5 Intraoperative endoscopic photographs. During the operation, the mass is well encapsulated and internal decompression performed using microdebrider (A). Tumor and origin site are totally resected (B). After the operation, grossly no tumor is observed (C).

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  Fig. 6 Histopathologic findings of the excised mass. Thin epidermis at top with variable ulceration and lobular pattern (A) of vascular proliferation with inflammation and edema resembling granulation tissue (B) are noted. Immunohistochemical staining for CD31 reveals positivity in the endothelium of the vessels (C), (D) [original magnification ×12.5 (A), (C) and ×400 (B and D)].

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