Abstract：
OBJECTIVE: Maxillary sinus carcinomas usually present as a locally advanced disease at the time of diagnosis and it is extremely unusual to have a second primary maxillary carcinoma on the contralateral side after many years of completion of treatment of the first malignancy. We present here a case report of a sphenopalatine artery (SPA) pseudoaneurysm mimicking the second primary maxillary carcinoma.
METHODS: We reviewed the literature for SPA pseudoaneurysm.
RESULTS: This report describes the case of a 90-year-old man with a background of adenoid cystic carcinoma of the right maxillary sinus, diagnosed and treated with surgery and radiotherapy 14 years ago, who presented with a history of multiple episodes of epistaxis. The radiological evaluation showed a heterogeneously enhancing mass with a central hemorrhagic component and surrounding bony erosions in the left maxillary sinus and the patient was planned for biopsy from the suspicious mass along with SPA ligation. However, on opening the maxillary antrum there was excessive bleeding and it was determined unsafe to proceed further. The patient was subsequently taken to interventional radiology for diagnostic angiography which revealed an SPA pseudoaneurysm that was subsequently embolized successfully.
CONCLUSIONS: Sphenopalatine artery pseudoaneurysms should be considered as a differential for recurrent epistaxis in patients with a history of sinonasal malignancy. In such cases, endovascular embolization is a viable management option.
METHODS: We reviewed the literature for SPA pseudoaneurysm.
RESULTS: This report describes the case of a 90-year-old man with a background of adenoid cystic carcinoma of the right maxillary sinus, diagnosed and treated with surgery and radiotherapy 14 years ago, who presented with a history of multiple episodes of epistaxis. The radiological evaluation showed a heterogeneously enhancing mass with a central hemorrhagic component and surrounding bony erosions in the left maxillary sinus and the patient was planned for biopsy from the suspicious mass along with SPA ligation. However, on opening the maxillary antrum there was excessive bleeding and it was determined unsafe to proceed further. The patient was subsequently taken to interventional radiology for diagnostic angiography which revealed an SPA pseudoaneurysm that was subsequently embolized successfully.
CONCLUSIONS: Sphenopalatine artery pseudoaneurysms should be considered as a differential for recurrent epistaxis in patients with a history of sinonasal malignancy. In such cases, endovascular embolization is a viable management option.
摘要：
目的：上颌窦癌通常在诊断时表现为局部晚期疾病，并且在完成对第一恶性肿瘤的治疗多年后，在对侧发生第二原发性上颌癌是极罕见的。我们在这里提供一例模仿第二原发性上颌癌的蝶窦动脉（SPA）假性动脉瘤的病例报告。
方法：我们回顾了SPA假性动脉瘤的文献。
结果：本报告描述了一名90岁的男性患者，其背景是右上颌窦腺样囊性癌，14年前接受手术和放疗的诊断和治疗，他有多次鼻出血的历史。放射学评估显示，左侧上颌窦存在中央出血性成分和周围骨侵蚀的非均匀增强肿块，并计划对患者进行可疑肿块的活检以及SPA结扎。然而,在打开上颌窦时，出血过多，因此确定进一步进行不安全。患者随后被送往介入放射科进行诊断血管造影，发现SPA假性动脉瘤，随后成功栓塞。
结论：对于有鼻腔鼻窦恶性肿瘤病史的患者，应考虑蝶呤动脉假性动脉瘤与复发性鼻出血的鉴别。在这种情况下,血管内栓塞是一种可行的治疗选择.
方法：我们回顾了SPA假性动脉瘤的文献。
结果：本报告描述了一名90岁的男性患者，其背景是右上颌窦腺样囊性癌，14年前接受手术和放疗的诊断和治疗，他有多次鼻出血的历史。放射学评估显示，左侧上颌窦存在中央出血性成分和周围骨侵蚀的非均匀增强肿块，并计划对患者进行可疑肿块的活检以及SPA结扎。然而,在打开上颌窦时，出血过多，因此确定进一步进行不安全。患者随后被送往介入放射科进行诊断血管造影，发现SPA假性动脉瘤，随后成功栓塞。
结论：对于有鼻腔鼻窦恶性肿瘤病史的患者，应考虑蝶呤动脉假性动脉瘤与复发性鼻出血的鉴别。在这种情况下,血管内栓塞是一种可行的治疗选择.
