(1226) Rare Cause of Nasal Obstruction Due to Angiomyoma

Introduction: Angiomyomas, sometimes referred to as angioleiomyomas or vascular leiomyomas, are rare, generally benign, vascular tumors derived from smooth muscle. Most cases reported in the literature involve the extremities, especially the lower extremities, which comprise 90% of cases. Less than 10% of cases have been identified in the head and neck, with less than 1% identified in the nasal cavity or sinuses. These tumors are diagnosed infrequently because complete surgical excision is necessary for histopathologic confirmation.

Methods: Case report of a patient with an angiomyoma of the nasal cavity and review of the literature.

Results: Patient is a 77-year-old female who presented with a two-year history of moderate, constant nasal congestion secondary to an enlarging nasal vestibular mass, without improvement with medical therapy. She reported that when first noted, she had a biopsy done, demonstrating “scar tissue.” Symptoms of nasal obstruction progressively worsened. Examination revealed a large firm cystic mass involving the right nasal vestibule arising from the lateral nasal wall. Complete surgical resection was performed. Histopathology demonstrated angiomyoma. Nasal obstructive symptoms resolved, and the postoperative course was uneventful.

Conclusions: Sinonasal angiomyoma is rare, with less than 1% of these benign vascular tumors found in this location. Nasal obstruction is best managed surgically with complete removal for symptom control and to establish a definitive diagnosis. The clinical management and histopathology of these tumors is reviewed.