Preoperative Embolization for Sinonasal Angiosarcoma Optimized Intraoperative and Postoperative Outcomes: A Case...

Area of Science:

• Oncology
• Head and Neck Surgery
• Vascular Tumors

Background:

• Angiosarcoma is a rare, aggressive cancer, comprising <1% of head and neck malignancies.
• Primary sinonasal angiosarcoma is exceptionally rare, with <40 cases documented.
• This tumor has a poor prognosis due to high recurrence and metastasis rates, lacking standard treatment.

Purpose of the Study:

• To highlight a rare case of sinonasal angiosarcoma.
• To emphasize the role of preoperative embolization in managing sinonasal angiosarcoma.
• To discuss optimal treatment strategies and long-term outcomes for sinonasal angiosarcoma.

Main Methods:

• A case report of a 33-year-old male with sinonasal angiosarcoma.
• Diagnostic imaging revealed a large, destructive sinonasal mass.
• Histopathology and immunohistochemistry confirmed the diagnosis.
• Preoperative embolization of feeding vessels was performed.
• Endoscopic resection with negative margins was achieved.
• Adjuvant radiotherapy was administered.

Main Results:

• Successful preoperative embolization led to near-complete devascularization.
• Endoscopic resection facilitated safe tumor removal with negative margins.
• The patient remained disease-free for over 65 months post-treatment.
• This represents one of the longest reported survivals for sinonasal angiosarcoma.

Conclusions:

• Sinonasal angiosarcoma is a rare, aggressive tumor that must be considered in differential diagnoses of sinonasal vascular lesions.
• Preoperative embolization is crucial for reducing intraoperative bleeding and enabling safe resection.
• Early diagnosis, multimodal therapy, and vigilant follow-up are vital for enhancing patient outcomes.