Sinonasal aneurysmal bone cyst mimicking hemangioma

Abstract

Abstract Background Aneurysmal bone cyst (ABC) is a benign, expansile bony lesion, primarily found in long bones. It is uncommon in facial bones and exceptionally rare in the sphenoethmoid sinus. Case presentation: A 28-year-old male presented with complaints of bilateral nasal block and recurrent epistaxis. Rhinoscopy examination showed a lobulated lesion in the bilateral posterior nasal cavity and nasopharynx. A nasopharyngeal angiofibroma was suspected on radiological assessment. Pre-operative incisional biopsy revealed the tumor as hemangioma. With a probable diagnosis of hemangioma, the lesion was explored under general anesthesia. An endoscopic endonasal excision of a tumor mass attached to the sphenoid skull base was undertaken. Histopathological examination of the resected tissue confirmed the diagnosis of an aneurysmal bone cyst. Conclusion ABC should be considered a rare differential for a hemorrhagic sinonasal mass in a young adult. Histopathological examination of the excised tissue is mandatory for a confirmatory diagnosis. Radiologic assessment and pre-operative incisional biopsy are essential from the diagnostic point of view; however, they can often cause a diagnostic dilemma with other vascular tumors such as nasopharyngeal angiofibroma or hemangioma.

Keywords

• Aneurysmal bone cyst
• Sphenoid sinus
• Posterior ethmoid sinus
• Blood-filled lesion