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Organised hematoma mimicking sino-nasal malignancy in patients post-radiotherapy
K-W Chiang1, C-Y Ho2
1Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans' General Hospital, Taiwan and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Introduction:
Organised hematoma (OH) in the para-nasal sinus and nasal cavity is a rare, non-neoplastic, benign disease which can be locally aggressive. In clinical practice, OH is easily misdiagnosed as malignancy and over-treated.
Case Summary:
These patients with OH had a common history of malignant neoplasms post-radiotherapy, including two cases of nasopharyngeal carcinoma and one case of tonsil cancer with jaw osteosarcoma. All of the patients presented with symptoms of epistaxis and blood-tinged rhinorrhea. All of the patients received endoscopic endonasal surgery under navigation.
Discussion:
All of the patients had a good recovery after surgery. There's no recurrence after follow-up at 6 months. We therefore hypothesised that radiotherapy could be a cause of the OH. Although OH is uncommon and difficult to diagnose, a history of malignancy and imaging features with appropriate treatment are key.
