Intravascular papillary endothelial hyperplasia of the maxillary sinus extending into the contralateral nasal cavity

TL;DR

A rare case of a nasal tumor called IPEH was successfully treated using a minimally invasive approach after being misdiagnosed due to its unusual location.

Contribution

This report presents a rare case of IPEH originating from the maxillary sinus extending into the contralateral nasal cavity.

Findings

IPEH was successfully removed using an endoscopic endonasal approach.

Computed tomography and MRI confirmed the tumor's extension into the nasal cavity.

The case highlights the importance of considering IPEH in differential diagnoses for nasal obstruction and epistaxis.

Abstract

Intravascular papillary endothelial hyperplasia (IPEH) predominantly occurs in the subcutaneous and dermal regions and rarely originates from the sinonasal mucosa.

We report on the case of a 58-year-old male patient who presented with progressive bilateral nasal obstruction, left-sided epiphora, and intermittent epistaxis. Computed tomography revealed a soft tissue opacity in the left maxillary sinus with intersinusoidal nasal wall demineralization, extending into the surrounding ethmoid cells and the right nasal cavity through a contralateral deviation of the nasal septum. Contrast-enhanced T1-weighted magnetic resonance imaging further confirmed these findings. The IPEH originating from the maxillary sinus extended into the contralateral nasal cavity, and it was successfully removed using an endoscopic endonasal approach, avoiding overly aggressive treatment.

This case report highlights the diagnostic challenges of IPEH in the sinonasal region and the importance of considering IPEH as a differential diagnosis in patients presenting with nasal obstruction, epiphora, and intermittent epistaxis.

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