ABSTRACT
INTRODUCTION AND IMPORTANCE: Capillary hemangioma of larynx can occur in both pediatric and adult population. However, epiglottic capillary hemangioma in adults is a very rare presentation. Its pathophysiological basis involves self limiting and self expanding vascularization and it is a characteristically well delineated benign mass. CASE PRESENTATION: Here we present a case of a 40-year-old female who presented with complaint of per oral bleed in spitting which was about a teaspoon in quantity since 1 month. There was no associated hoarseness, dysphagia, respiratory distress, hemoptysis or neck swelling. There were no other systemic manifestations i.e. weight loss, fatigue or anemia. There was no familial history. CLINICAL DISCUSSION: On examination, Indirect Laryngoscopy (IDL) revealed a mass on the posterior surface of epiglottis. 70° view endoscope confirmed the findings of IDL. All other neighboring structures i.e. vocal cords, anterior and posterior commissures and pyriform fossa were normal and no mass or pathology was seen. Imaging studies contrast enhanced CT scan of neck soft tissue window showed isodense opacity in supraglottic region. Surgical excision and hemostasis were carried out using Colorado bipolar cauterization. The histopathological investigation of the mass revealed a benign lesion compatible with capillary hemangioma. CONCLUSION: As until now, no case of capillary hemangioma of epiglottis has been reported, head and neck surgeons are not well aware of this case. This case report will add valuable insight to the relative surgeons/clinicians.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Lobular capillary hemangioma (LCH) is a benign vascular lesion typically affecting the head and neck region, especially the nasal cavity. However, its occurrence in the nasal cavity of the pediatric population is rare, making its diagnosis and management crucial in such cases. CASE PRESENTATION: A 7-year-old female presented with left-sided nasal obstruction and recurrent epistaxis for 4 months. Examination revealed a dark purplish-red nasal mass, which bled easily upon probing. CT scans showed a soft tissue lesion with post-contrast enhancement. Histopathological examination confirmed lobular capillary hemangioma. The patient successfully underwent surgical excision without pre-operative embolization. CLINICAL DISCUSSION: LCH affects both the skin and mucous membranes. Although its exact etiology remains debated, trauma is a leading risk factor for its development. Biopsy and radiological investigations confirm its diagnosis. Differentiating LCH from other vascular disorders with similar presentations is essential for a thorough understanding and better management. Endoscopic surgical excision combined with electrodesiccation is the treatment of choice. CONCLUSION: Intranasal LCH in children is infrequent. An accurate diagnosis is essential for a comprehensive understanding. Surgical excision with electrodesiccation is the preferred treatment, but the role of pre-operative embolization is still under discussion.
