PMC6167579_01
Axial and coronal sinus CT scans with contrast showing a heterogeneously enhanced mass involving the middle and lower meatus of the left nasal cavity with normal adjacent bony structures. In its maximum dimensions, the mass measured 3.2 x 2.2 x 1.5 cm.
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On the same day, a contrasted CT scan of the paranasal sinuses was scheduled, which revealed a heterogeneously enhanced soft tissue mass involving the middle and lower meatus of the left nasal cavity measuring 3.2 x 2.2 x 1.5 cm with normal adjacent bony structures (Figure 1).
A preoperative endoscopic examination revealed a mass occupying the left nasal cavity.
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During intraoperative examination using a telescope, a large, well-circumscribed, red, smooth mass occupying the left nasal cavity and originating from the medial surface of the inferior turbinate and the inferior surface of the posterior part of the middle turbinate was visualized without any attachment to the nasal septum (Figure 2).
An intraoperative endoscopic examination after complete excision of a left nasal cavity mass revealed two sites of origin in the lateral nasal wall: the medial surface of the inferior turbinate and the inferior surface of the posterior part of the middle turbinate.
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The mass was initially injected with lidocaine and epinephrine (1 : 100,000) and then excised completely from its site of origin via bipolar diathermy which resulted in no significant bleeding (Figure 3).
Gross appearance of the mass after excision, which had a smooth and glistening surface.
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Gross histopathological analysis revealed a polypoidal tissue mass measuring 3.0 x 1.5 x 1.0 cm with a smooth and glistening surface (Figure 4).
Microscopic examination of the tumor revealed lobulated and dilated capillaries with edematous stroma, confirming the diagnosis of lobular capillary hemangioma.
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Based on this, a diagnosis of LCH was made (Figure 5).
A 3-month postoperative examination via endoscopy indicating good mucosal healing at the site of procedure with no evidence of recurrence.
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The patient was completely asymptomatic during follow-up appointments in our clinic at two weeks, one month, three months, and six months postoperatively, with healthy mucosa and no evidence of mass recurrence during endoscopic nasal examination (Figure 6).