Pediatric Intranasal Lobular Capillary Hemangioma: A Rare Clinical Entity

Address for Correspondence: Dr. Uğur Yıldırım, Department of Otolaryngology and Head and Neck Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey Phone: +90 505 631 39 11 e-mail: [email protected] Received: 10 May 2017 Accepted: 25 June 2017 • DOI: 10.4274/balkanmedj.2017.0496 Available at www.balkanmedicaljournal.org Cite this article as: Yıldırım U, Karlı R, Gün S. Pediatric Intranasal Lobular Capillary Hemangioma: A Rare Clinical Entity. Balkan Med J 2017;34:586-7 ©Copyright 2017 by Trakya University Faculty of Medicine / The Balkan Medical Journal published by Galenos Publishing House. A 9-year-old male presented to our clinic with symptoms of a right-sided intermittent epistaxis for the past one year. There was no headache, fever, trauma, nasal packing or history of foreign body. Besides there was no similar symptoms or illness in the family. On physical examination, both nasal cavities were normal in anterior rhinoscopy. The patient and her parents were informed about endoscopic nasal examination and after thier permittion, endoscopic nasal examination was performed. Endoscopic nasal examination revealed that a violescent mass which located between inferior turbinate and nasal septum at the posterior one-third of the right nasal cavity. The origin of the mass couldn’t be identified. The ear and throat examination was normal. Furthermore complete blood count and routine biochemical analysis were normal. Axial and coronal nasal and paranasal sinus computed tomography was performed. computed tomography revealed a right-sided soft tissue mass arising from posterior part of the inferior turbinate, and maxillary and ethmoid sinusitis (Figure 1). Informed consent was taken from the patient’s parents. Endoscopic intranasal excision was performed under general anesthesia. In the right nasal cavity, there was a pedunculated, purplish, irregular necrotic mass which bleeds on touch originating from a region near the base at the posterior one-third of the nasal septum (Figure 1b). The lesion and the septal mucousa which was source of the mass was completely excised using cold dissection (Figure 1c). The patient was discharged without any complication two days after the operation. Histopathologic examination revealed lobular capillary hemangioma (Figure 1d). No recurrence was observed in the 3-month after the surgery. Lobular capillary hemangioma which is also known as pyogenic granuloma typically occurs on the skin and in the oral cavity. Nasal cavity is an uncommon area for lobular capillary 1Department of Otolaryngology and Head and Neck Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey 2Department of Pathology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey Uğur Yıldırım1, Rıfat Karlı1, Seda Gün2