Hemangiomas of the nasal cavity are extremely rare in the practice of an otorhinolaryngologist and can be presented in various histopathological variants. Scientific data on hemangiomas of the sinonasal region are analyzed and systematized. The article describes the principles of diagnosis and choice of the method of surgical treatment of hemangiomas. An analysis of the literature data shows that with hemangiomas of the nasal cavity, a comprehensive examination of the patient is required, including collection of complaints and anamnesis, endoscopy of the nasal cavity and computed tomography of the paranasal sinuses, and with significant hemangiomas spreading to neighboring anatomical areas, magnetic resonance imaging with intravenous contrast.
Гемангиомы полости носа встречаются крайне редко в практике врача-оториноларинголога и могут быть представлены в различных гистопатологических вариантах. Проанализированы и систематизированы научные данные по гемангиомам синоназальной области. В статье описаны принципы диагностики и выбора метода хирургического лечения гемангиом. Анализ данных литературы показывает, что при гемангиомах полости носа требуется проведение комплексного обследования пациента, включающего сбор жалоб и анамнеза, эндоскопию полости носа и компьютерную томографию околоносовых пазух, а при значительных размерах гемангиомы с распространением в соседние анатомические области — магнитно-резонансную томографию с внутривенным контрастированием.

UNASSIGNED: Intraosseous hemangiomas are rare benign tumors comprising fewer than 1% of all osseous tumors; even more uncommon are intraosseous hemangiomas of the zygomatic bone. This case reports a multidisciplinary approach for excision and reconstruction of an intraosseous hemangioma of the zygomatic bone in a 54-year-old female.
UNASSIGNED: Multidisciplinary approach with both otolaryngology head and neck surgery and oculofacial plastics and reconstructive surgery included right lateral canthotomy and right transconjunctival orbitotomy with en-bloc excision of the zygomatic arch, followed by reconstruction of the orbital rim, orbital floor, and eyelid with Medpor implant.
UNASSIGNED: Final surgical pathology was consistent with intraosseous hemangioma of the zygomatic bone. At 4-month follow-up, the patient was healing well with good midface projection and without any visual deficits.
UNASSIGNED: A multidisciplinary coordinated case allowed us to meet the standard of maintaining cosmesis and function while undergoing resection of a rare tumor involving a key facial structure-the zygoma. Involvement of oculofacial plastics and reconstructive surgery service allowed for advanced eyelid reconstruction techniques to limit any functional impairment to our patient with deliberate choice of implant material for well-adhered, durable, and aesthetically optimal reconstruction of the right malar eminence, lateral orbital rim, and orbital floor defect. The postoperative result through the multidisciplinary approach was a near symmetrical facial reconstruction without any associated eyelid or globe abnormalities.

Capillary intraosseous hemangioma is a benign vascular neoplasm that affects bone tissue, yet its occurrence in the jaw bones has been seldom reported in the literature. We present a case of a capillary intraosseous hemangioma located in the mandibular symphysis of a 28-year-old male. Initially addressed by the patient\'s dentist as an infectious lesion of endodontic origin, the sudden worsening of the condition, marked by the development of a rapidly expanding exophytic mandibular lesion and tooth mobility, led to the consideration of various potential diagnoses. Subsequently, an incisional biopsy was performed, triggering multiple episodes of recurrent bleeding, leading to several visits to the emergency department, and prompting an urgent status upgrade for the patient. Upon the histological diagnosis of vascular neoplasm, the patient underwent the excision of the lesion, with a favorable and uneventful evolution, although with expected sequelae. As a result, a temporary prosthetic solution, comprising a Maryland Bridge, was implemented, with plans for guided bone regeneration and implant-supported fixed dental prostheses currently in progress. This case underscores the diagnostic and therapeutic challenges associated with this rare condition. Consequently, achieving the optimal outcome for the patient largely depends on a multidisciplinary approach, emphasizing the critical importance of thorough preoperative assessment, along with a well-devised treatment plan and rapid intervention.

Intraosseous vascular pathology of the turbinates is extremely rare in the practice of an otorhinolaryngologist and can be presented in various histopathological variants. The article presents two clinical cases in which an intraosseous cavernous hemangioma was hidden under the mask of a hypertrophied middle turbinate. The final diagnosis was established by the results of histological examination. The analysis of these clinical cases indicates that, despite the low prevalence, atypical clinical and CT picture, intraosseous formations of the nasal cavity can be of a vascular nature and certainly require a comprehensive examination, including CT, CT with contrast and/or MRI of the nose and paranasal sinuses. These clinical observations indicate that preliminary embolization of feeding vessels before surgical treatment is not required.
Внутрикостная сосудистая патология носовых раковин встречается крайне редко в практике врача-оториноларинголога. Она может быть в различных гистопатологических вариантах. В статье представлены два клинических случая, в которых под маской гипертрофированной средней носовой раковины скрывалась внутрикостная кавернозная гемангиома. Окончательный диагноз был установлен по результатам гистологического исследования. Разбор данных клинических случаев свидетельствует о том, что, несмотря на низкую распространенность, нетипичную клиническую и КТ-картину, внутрикостные образования полости носа могут иметь сосудистую природу и, безусловно, требуют комплексного обследования, включая КТ, КТ с контрастированием и/или МРТ носа и околоносовых пазух. Данные клинические наблюдения свидетельствуют о том, что предварительная (до хирургического лечения) эмболизация питающих сосудов не требуется.

Two patients with papillary thyroid carcinoma and an elevated thyroglobulin had false-positive imaging studies from intraosseous hemangiomas (IH). A 62-year-old man presented with a palpable lytic skull mass suspicious for a bone metastasis after computed tomography (CT) and magnetic resonance imaging (MRI) scans. Surgical excision confirmed an IH. The second patient is a 64-year-old woman whose I-123 whole-body scan with single photon emission computed tomography/CT demonstrated radioiodine uptake in the right frontal bone. Her MRI and CT scans were also consistent with an IH. These cases reveal the limitations of nuclear imaging and of CT and MRI scans in distinguishing metastatic differentiated thyroid cancer from IH in patients with lytic bone lesions. Because no imaging studies are definitive for an IH, bone cranial lesions may warrant resection to establish a diagnosis and avoid potential brain invasion by a malignancy or unnecessary radioiodine treatment.

Osseous vascular anomalies can be characterized as vascular tumors or malformations. Classification is vital for prognosis and treatment. Much remains unknown about conditions such as Gorham-Stout disease. Treatments target the proposed genetic pathways such as PI3KCA/AKT/mTOR pathway.

An intraosseous hemangioma is a rare benign tumor of the bone. Moreover, it is rarely observed in the nasal bone. A 58-year-old female patient complained of swelling in the nasal dorsum and mild pain. CT showed a round mass with a honeycomb appearance meanwhile, MRI revealed a hypointense mass in T1 sequences and hyperintense in T2 and gadolinium sequences. Endoscopic removal of the intraosseous hemangioma was performed. No recurrence was observed in the post-op 6th-month follow-up.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-03729-x.

Papillary hemangioma is a novel variant of intravascular hemangioma. It is more common in adults and has a male predominance. Most tumors reported so far are solitary and cutaneous. Here we present a rare case of an intraosseous papillary hemangioma involving the frontal bone. Brain imaging in a 69-year-old man with a slowly enlarging swelling on the right frontal area following an accidental fall demonstrated a 4.5 cm × 1.7 cm × 4.2 cm mass originating from the right frontal bone, with a tiny defect on the orbital roof. A malignant process was favored, and the mass was removed. Histopathology revealed a vascular lesion showing intraosseous distribution with foci of extension into the fibrous connective tissue. There were areas of plump endothelial cells with intracytoplasmic hyaline globules arranged in papillary configuration. The lesional cells were immunoreactive with CD34. AE1/AE3, EMA, PR, D2-40, inhibin, and S100 stains were negative. Ki-67 was low. This is the first intraosseous and second noncutaneous papillary hemangioma. Clinically it differs from other cases by the presence of trauma as a preceding event. Since its prognosis is unknown such patients should be monitored for recurrence or malignant transformation.

OBJECTIVE: Describe imaging features of intraosseous hemangiomas located outside of the mobile spine and calvarium.
METHODS: Imaging and medical records were retrospectively reviewed for cases of intraosseous hemangiomas located outside of the calvarium and mobile spine. Evaluation included patient demographics, histologic confirmation, and imaging characteristics.
RESULTS: Thirty-six patients were included (25 F, 11 M; mean age 54 ± 17 years, range 10-84 years) with 37 total lesions (70% axial and 30% appendicular skeleton). Mixed lytic and sclerotic features were identified on 83-85% radiographs and CTs. Amorphous increased density mimicking osteoid matrix was present on 38-45% radiographs and CTs. Classic honeycomb or radial pattern was identified on 45% of CTs. Osseous expansion and cortical permeation were common features. CT identified periosteal reaction in 24% of lesions. All hemangiomas had heterogeneous MRI signal and most moderately or avidly enhanced. Intralesional fat was identified on 78% MRIs, often as a minor component and only detected on 24% of CTs. A soft tissue mass was present on 52% of MRIs. FDG PET/CT mean SUVmax of 3.2 ± 0.6 (range 1.9-5.0). Lesional FDG activity relative to background marrow was increased in 75% of lesions. Lesions with cortical permeation had higher metabolic activity versus those without (3.5 ± 0.7 versus 2.2 ± 0.3, p = 0.041).
CONCLUSIONS: Intraosseous hemangiomas outside of the mobile spine and calvarium demonstrate more aggressive imaging features compared to vertebral hemangiomas, including cortical permeation, soft tissue mass, amorphous increased density mimicking osteoid matrix, and increased FDG activity.

A 28-year-old female presented with a slowly enlarging, left cheek mass over two years. She underwent neuroimaging and was found to have a well-defined, low attenuating lesion with thickened vertical trabeculation of the left zygoma, consistent with intraosseous hemangioma. To minimize the risk of severe intraoperative hemorrhage, the patient underwent embolization of the mass by neuro-interventional radiology two days prior to resection. The patient subsequently underwent a left anterior orbitotomy and partial zygoma resection followed by reconstruction of the lateral orbit with a custom porous polyethylene zygomaxillary implant. The postoperative course was uneventful with a good cosmetic outcome.