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Revista de la Asociación Médica del Centro Médico ABC

2019, Number 4

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An Med Asoc Med Hosp ABC 2019; 64 (4)

Nasal capillary lobular hemangioma of the middle turbinate: a rare cause of recurrent epistaxis

Marino SJA, Gutiérrez SG, Fernández EJ, Cuesta MTC, Guerrero HM

Language: Spanish
References: 15
Page: 312-316
PDF size: 322.22 Kb.


ABSTRACT

Epistaxis is the most common emergency in otolaryngology that general practitioners and specialists confront. Incidence is uncertain because most cases resolve spontaneously. It can be classified in anterior (85-90%) and posterior (15-10%) usually and the last is the one that requires more often urgent medical attention. There are multiple causes which can be anatomical, medical, tumoral (benign and malignant) or traumatic. The clinician must have a sound differential diagnosis armamentarium to treat the different causes focused on the etiology. We present the case of a 43 year old male patient, with no previous medical history, with recurrent unilateral epistaxis. The patient was previously seen at the emergency department in two occasions before consulting with us. He had required anterior nasal packing in two occasions without solving the epistaxis. In the endoscopic exploration of the nasal cavity we found a tumor dependent of the middle turbinate with a red-blue appearance, which was the site of bleeding. In the CT scan and MRI of the head we found an image compatible with a vascular tumor dependent of the right middle turbinate. Previous angioembolization, the tumor was excised with nasal endoscopic surgery with the assistance of navigation system. The histopathology was compatible with a lobular capillary hemangioma. The patient was followed up for 6 months with no recurrence. The purpose of this clinical case is to provide another differential diagnosis to the armamentarium of clinicians handling patients with epistaxis, as this tumor rarely appears in the middle turbinate.


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