Journal of Otolaryngology Head & Neck Surgery Category: Clinical Type: Case Report
Epithelioid Hemangioendothelioma of Pterygomaxillary Fissure
- Maria Beatriz Nogueira Pascoal1, José Francisco De Sales Chagas2*, Fernanda Garcia Callegari3, Thalita Dos Reis Ruba3, Marilia De Oliveira Coelho Dutra Leal4, Cláudio Roberto Pacheco Jodas5
- 1 Department Of Head And Neck Surgery, São Leopoldo Mandic Medical School , Campinas, Brazil
- 2 Department Of Head And Neck Surgery, São Leopoldo Mandic Medical School, Campinas, Brazil
- 3 Catholic University Medical School, Campinas, Brazil
- 4 Department Of Morphology, School Of Dentistry Of Piracicaba (University Of Campinas), Campinas, Brazil
- 5 Department Of Maxillo Facial Surgery, São Leopoldo Mandic Dentistry School, Campinas, Brazil
*Corresponding Author:José Francisco De Sales Chagas
Department Of Head And Neck Surgery, São Leopoldo Mandic Medical School, Campinas, Brazil
Received Date: Apr 25, 2017 Accepted Date: Jul 17, 2017 Published Date: Jul 31, 2017
Epithelioid Hemangioendothelioma (EH) is an uncommon vascular neoplasm (endothelial origin) which can affect any type of tissue. It rarely occurs in head and neck region, and has unpredictable clinical behavior.
The aim is to report a case of EH of unusual location (pterygomaxillary fissure) and histological rarity, andto establish an accurate differential diagnosis of EH and Juvenile Nasoangiofibroma (JNA).
A 19 year-old male with a chief complaint of recurrent epistaxis and an obstruction of the left nasal cavity. The diagnosis of JNA was suggested and surgery with tumor complete resection was the election treatment. However, clinical diagnosis was not confirmed postoperaively, through Immunohistochemistry (IHC). Histopathological findings showed a diagnostic reporting of EH. Tumor had no recurrence within three years after surgery.
Apart from the rarity of the condition, EH varies according to their location in asymptomatic or with few symptoms. The presence of violaceous lesions indicates a huge range of vascular tumors. Thus, IHC has assumed very important for diagnosis confirmation.
The localization of EH in perygomaxillary fissure is a rare condition withpoor prognosis. The treatment choice for EH was the complete ressection.
Figure 1A and 1B: Black circles in contrast-enhanced computed tomography (coronal and transverse sections, respectively) indicates HE localization in left side and structures envolved: pterygomaxillary fissure, nasal cavity, maxillary and sphenoid sinuses and upper limit near the greater wing of the sphenoid bone region.
Figure 2: Surgical specimen.
However, immunohistochemistry (CD34 marker) of tumor resection demonstrated that tumor was an EH. The presence of cellular atypia and mitotic frames are compatible with malignancy. There were no signs of neoplasia in bone tissue (Figure 3). Follow-up exams, quarterly periodical, were: nasopharyngolaryngoscopic and contrast-enhanced computed tomography, and there was no evidence of recurrence in three years.
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Citation:Pascoal MBN, Chagas JFDS, Callegari FG, Ruba TDR, Leal MDOCD, et al. (2017) Epithelioid Hemangioendothelioma of Pterygomaxillary Fissure. J Otolaryng Head Neck Surg 3: 011.
Copyright: © 2017 Maria Beatriz Nogueira Pascoal, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.