비강 및 부비동에 범발한 혈관종

Hemangiomas involving the paranasal sinuses are rare. They are described to be a well circumscribed, intensely enhancing mass, causing benign appearing bone changes at CT scan. We report 4 cases of hemangiomas involving the nasal cavity, maxillary sinus, and ethmoidal sinus, presented with refractory epistaxis, and easily bleeding, friable intranasal mass. CT scan showed a large, inhomogenously enhancing mass with significant bone erosion, which made it difficult to differentiate hemangiomas from the most common malignant epithelial tumors on the basis of the imaging findings. Medial maxillectomy by midface degloving, rather than lateral rhinotomy with lip splitting, was recommended for surgical excision. Major intraoperative bleeding was avoided by the use of adjunctive preoperative embolization or by intraoperative ligation of the external carotid artery.