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Lobular capillary hemangioma of the nasal cavity: A retrospective study on 40 patients
Roberto Puxeddu1, Marco Berlucchi, Gian Peppino Ledda
1Department of Surgical Sciences and Organ Transplantations, Section of Otorhinolaryngology, University of Cagliari, Cagliari, Italy.
Insights
Nasal lobular capillary hemangioma (LCH) is a benign vascular lesion. Endoscopic resection is the preferred treatment, with no recurrences observed in this large patient series.
Area of Science:
- Otolaryngology
- Pathology
- Radiology
Background:
- Nasal lobular capillary hemangioma (LCH) is a benign vascular lesion of unknown cause.
- It requires consideration in the differential diagnosis of nasal vascular lesions.
- This study analyzes a large cohort of LCH patients.
Purpose of the Study:
- To retrospectively analyze clinical presentation, histological, and radiological findings.
- To evaluate treatment strategies for nasal LCH.
- To report outcomes of endoscopic resection for nasal LCH.
Main Methods:
- Retrospective review of clinical records from 40 LCH patients over 20 years.
- Data collected included symptoms, etiology, endoscopic findings, imaging, and treatment.
- Analysis of surgical outcomes and recurrence rates.
Main Results:
- Epistaxis (95%) and nasal obstruction (35%) were primary symptoms.
- Lesions varied in size (1-8 cm), commonly on the septum (45%).
- Endoscopic resection was successful with no recurrences at a mean 53-month follow-up.
Conclusions:
- This is the largest reported series of nasal LCH.
- Imaging can aid diagnosis of large lesions, potentially avoiding biopsy.
- Endoscopic surgery is the treatment of choice, even for large lesions, without needing preoperative embolization.
Background:
Nasal lobular capillary hemangioma (LCH) is a benign lesion of unknown etiology that must be included in the differential diagnosis of vascular lesions. Based on a large cohort of LCH patients, we retrospectively analyzed the clinical presentation, histological and radiological findings, and the treatment strategy.
Methods:
Clinical records of 40 patients affected by LCH, treated in a 20-year period at two university hospitals, were reviewed. Data concerning symptoms, possible etiologic factors, endoscopic findings, imaging studies, and treatment were collected.
Results:
Previous nasal trauma and pregnancy were identified as possible causes in six (15%) and two (5%) patients, respectively. The main symptoms were unilateral epistaxis (95%) and nasal obstruction (35%). Lesions ranged in size from 1 to 8 cm and mainly involved the nasal septum (45%) and the nasal vestibule (17.5%). In the four (10%) patients with a large lesion, radiological evaluation was helpful not only in assessing the extent, but also in suggesting the possible nature of the lesion. All patients underwent endoscopic resection under local (72.5%) or general (27.5%) anesthesia. At mean follow-up time of 53 months, no recurrence has been observed.
Conclusion:
To the best of our knowledge, this is the largest series of patients with nasal LCH. When the mass is considerable in size, differentiation from other hypervascularized lesions may be intriguing. Under these circumstances, information obtained with imaging may sometimes suggest a correct diagnosis without resorting to biopsy. Endoscopic surgery is the treatment of choice even for large lesions, that do not require preoperative embolization.