%0 Journal Article
%T Endoscopic Resection of Sinonasal Hemangiopericytoma following Preoperative Embolisation: A Case Report and Literature Review
%A Georg J. Ledderose
%A Donata Gellrich
%A Markus Holtmannsp£¿tter
%A Andreas Leunig
%J Case Reports in Otolaryngology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/796713
%X Objectives. Hemangiopericytoma is a rare tumor entity deriving from pericytes. Less than 5% of hemangiopericytoma occur in the nasal cavity and are characterised by a rather benign nature with low tendency of metastasis. However, as the recurrence rate in the literature ranges from 9.5% to 50%¡ªdepending on the length of followup¡ªa radical surgical resection is considered as the gold-standard treatment. Only a few years ago, a wide external approach, usually via lateral rhinotomy or Caldwell-Luc, was performed. Endoscopic techniques were regarded as appropriate for small low-vascularised tumors only. Methods. We present the case of a 64-year-old patient with an extended sinonasal hemangiopericytoma, who was successfully treated by an endoscopic controlled endonasal tumor resection after embolisation with Onyx. Further, to support the new treatment option, we review the literature concerning all features of sinonasal hemangiopericytomas and their therapeutical management. Results/Conclusion. Onyx, which has not been described in the context of hemangiopericytoma yet, is a very effective embolic agent for a preoperative embolisation of sinonasal hemangiopericytoma allowing a safe endoscopic surgery. 1. Introduction Sinonasal hemangiopericytomas are a rare upper aerodigestive tract tumor deriving from perivascular modified smooth muscle cells. This vascular neoplasm firstly described in 1943 by Stout and Murray [1] may arise in any part of the body [2]; only 15%¨C30% are located in the head and neck region [3]. Of these, only 5% are found in the nasal cavity and paranasal sinus [4]. Hemangiopericytoma located in the nasal region is frequently characterized by a more benign nature with low tendency of metastasis [5]; however, sinonasal hemangiopericytoma exhibits a recurrence rate of approximately 25% [3]. In the last two decades, less than 250 cases have been published so that sinonasal hemangiopericytoma represents a rather rare tumor entity. A total of 57 patients out of the 250 analysed cases underwent an endoscopic tumor resection, of which 23 patients received a preoperative embolisation of the high vascularised hemangiopericytoma. Here, we review the relevant literature and report about a 64-year-old patient presenting with sinonasal hemangiopericytoma. We used a liquid embolic agent, consisting of an ethylene vinyl alcohol dissolved in the organic solvent dimethyl sulfoxide (DMSO) and containing tantalum powder for radiopacity (Onyx) and performed an endoscopically controlled resection. To our knowledge, this is the first report about preoperative
%U http://www.hindawi.com/journals/criot/2013/796713/