A Case of Epithelioid Hemangioendothelioma on the Choana

Jung Heob Sohn; Kyoung Rai Cho

doi:10.18787/jr.2018.25.2.118

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Sohn and Cho: A Case of Epithelioid Hemangioendothelioma on the Choana

Case Report

Journal of Rhinology 2018; 25(2): 118-122.

Published online: 30 November 2018

DOI: https://doi.org/10.18787/jr.2018.25.2.118

A Case of Epithelioid Hemangioendothelioma on the Choana

Jung Heob Sohn, MD, Kyoung Rai Cho, MD, PhD

Department of Otorhinolaryngology-Head and Neck Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea.

Corresponding author (entr1@naver.com)

Received 19 October 2017 Revised 15 June 2018 Accepted 25 August 2018

Journal of Rhinology

Abstract

Epithelioid hemangioendothelioma is a rare vascular tumor with intermediate malignity and metastasis risk. It presents epithelioid cells with intracytoplasmic vacuoles and low mitotic activity. Its vascular nature can be confirmed by immunohistochemical studies (vimentin, CD31, CD34, and factor VIII). It is extremely rare in the nasal cavity, with only one case reported on the middle turbinate in Korea. The authors present a case of epithelioid hemangioendothelioma on the choana with a size of 2mm, which easily coult have been misdiagnosed as a blood clot.

Keywords: Epithelioid hemangioendothelioma, Epistaxis, Nasal cavity

Figures and Tables

Fig. 1

Preoperative endoscopic finding shows large hematoma occupying the choana and the nasopharyngeal space. Right-sided view (A) and left-sided view (B).

Fig. 2

Axial (A) and coronal (B) CT image shows that ill-defined enhancing soft tissue density fills up the posterior nasal cavity and the nasopharyngeal space (black dotted circle). 1–2 mm sized nodule with enhancement is seen on medial choanal arch (white arrow).

Fig. 3

The tumor appeared as a nodular mass composed of abundant vascular channels (H&E, ×10) (A). There are spindle cell proliferation around the vessels (H&E, ×100). The tumor cells are vacuolated with intracytoplasmic erythrocytes (white arrows in yellow box) (B).

Fig. 4

The site of the lesion is well recovered and no recurrence is observed on postoperative endoscopic findings in 3 weeks (A) and 21 months (B) after the surgery.

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