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Year: 2013  Vol. 17   Num. Suppl. 1  - Print:
MAXILLARY SINUS HEMANGIOMA
Author(s):
Carlos Toyama, Carlos Jorge da Silva, Henrique Bortot Zuppani, Lidio Granato, Renato H Nunes, Stefano Tincani
Abstract:

Purpose: To report the CT and MRI characteristics of a maxillary sinus hemangioma in a patient from our institution. CASE REPORT: A 27-year-old man presented with left frontal and maxillary pain, rhinorrhea, and bilateral nasal congestion, as well as greenish secretions over 4 years that had become more intense in the last 6 months. A CT scan demonstrated a soft tissue mass with calcifications and heterogeneous enhancement causing expansion of the left maxillary sinus, thinning of its medial wall, and extension into the nasal cavity. MRI showed a heterogeneous mass, slightly hyperintense on T1, markedly hyperintense with complete peripheral hypointense rings on T2, and consistent with various blood degradation products. The remaining left maxillary sinus evidenced a high signal on T2, consistent with secretions and a mucosal inflammatory reaction. Surgical resection revealed a mass with hemorrhagic products and necrotic areas compatible with cavernous hemangioma. CONCLUSION: Hemangiomas are vascular lesions that rarely compromise the paranasal cavities. Imaging features have been rarely reported, and the preoperative presumptive diagnosis is important for surgical planning. The presence of small vascular calcifications (phleboliths) is a major finding with a high specificity for the correct diagnosis. A hemangioma may show heterogeneous signal intensity on MRI sequences resulting from various blood degradation products associated with intratumoral vascular thrombosis.

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