Management of sinonasal hemangiopericytomas: a systematic review

Authors

  • Mufaddal Q. Dahodwala MS,

    1. Department of Otolaryngology–Head and Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
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  • Qasim Husain BS,

    1. Department of Otolaryngology–Head and Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
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  • Vivek V. Kanumuri BS,

    1. Department of Otolaryngology–Head and Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
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  • Osamah J. Choudhry MD,

    1. Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
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  • James K. Liu MD,

    1. Department of Otolaryngology–Head and Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
    2. Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
    3. Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
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  • Jean Anderson Eloy MD, FACS

    Corresponding author
    1. Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
    2. Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
    • Department of Otolaryngology–Head and Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, NJ
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  • Additional Supporting Information may be found in the online version of this article.

  • Potential conflict of interest: None provided.

  • Presented at the 58th Annual Meeting of the American Rhinologic Society, Washington, DC, September 8, 2012.

Correspondence to: Jean Anderson Eloy, MD, FACS, Rhinology and Sinus Surgery, Department of Otolaryngology–Head and Neck Surgery, UMDNJ–New Jersey Medical School, 90 Bergen St., Suite 8100, Newark, NJ 07103; e-mail: jean.anderson.eloy@gmail.com

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

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