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Management of sinonasal hemangiopericytomas: a systematic review
Article first published online: 6 FEB 2013
© 2013 ARS-AAOA, LLC
International Forum of Allergy & Rhinology
Volume 3, Issue 7, pages 581–587, July 2013
How to Cite
How to Cite this Article: Management of sinonasal hemangiopericytomas: a systematic review. Int Forum Allergy Rhinol, 2013; 3:581–587., , , , , .
Potential conflict of interest: None provided.
Presented at the 58th Annual Meeting of the American Rhinologic Society, Washington, DC, September 8, 2012.
- Issue published online: 22 JUL 2013
- Article first published online: 6 FEB 2013
- Manuscript Accepted: 17 NOV 2012
- Manuscript Revised: 17 AUG 2012
- Manuscript Received: 28 JUN 2012
- sinonasal tumors, epistaxis;
- sinonasal hemangiopericytoma;
- malignant sinonasal tumors;
- endoscopic sinus surgery;
- endoscopic skull base surgery;
- perivascular tumors, systematic review
Hemangiopericytomas are typically found in soft-tissue, but only rarely found in the sinonasal tract. Sinonasal hemangiopericytomas have been reported mostly through case studies, and optimal treatment is considered surgical excision. Classically, open surgical methods of tumor extirpation have been considered standard of care. With the wider use of endoscopic methods, an updated systematic review in terms of treatment is warranted.
Cases were identified using a MEDLINE and PubMed search. Relevant studies were identified, and data was extracted regarding patient demographics, presenting symptoms, tumor characteristics, treatment, and outcomes.
A total of 128 cases were collected from 56 articles, consisting of case reports and series. The most common presenting symptoms were epistaxis, nasal obstruction, and facial pain/swelling/pressure. Computed tomography (CT) and X-ray were the most common modes of imaging during diagnosis and operative planning. The tumor often occupied multiple locations in the sinonasal tract at initial presentation. Surgical resection was the mainstay of treatment in 126 of the 128 cases (98.4%), either through open resection or endoscopic techniques. Surgical removal resulted in no recurrence in 79.7% of the cases. The use of endoscopic techniques increased significantly in the past decade. This review found no significant difference in terms of recurrence between endoscopic and open treatment groups, age, gender, and unilocality vs multilocality of tumor.
Surgical management remains the mainstay of treatment for hemangiopericytomas. Endoscopic resection of these lesions has increased over the last few decades and has become a safe, viable, and reasonable alternative to open resection.