A Case of Nasal Hæmangioma with Unusual Features

Hemangioma of the Nasal Septum: A Clinicopathological Profile

“…"Bleeding polyps" of the nasal septum were described more than ninety years ago by Pierce [5] and Schadewaldt [6]. "Polypoid hemangiomas" (Callison [7]) and "septal angiomas" (Dabney [8]) were other terms used to describe the same condition.…”

“…Havens and Lockhart [19] referred to "embryonic sequestrations of angioblasts present at birth." Smith and Pierce proposed the hormonal theory and reported, respectively, a case of septal hemangioma occuring during pregnancy [6] and a girl whose intranasal lesion bled during menses [5]. Osborn [14] theorized that "these angiomas are explained by the opening up of pre-existing non-patient channels."…”

“…Surgical excision is preferred by most authors. Mayer and Gluckman [6] stress the importance of excising a "cuff of underlying mucosa and perichondrium"; failure to do so increases the chances of recurrence.…”

Unilateral Dermatomal Superficial Telangiectasia

“…There are reports of spinal angiomata [Newman, 1958;N ewquist and Mayfield, 1960], a nasal angioma [Smith, 1959] and many other angiomata [Winer and Levin, 1959;Barter eta!., 1963;Laugier and Hunziker, 1971] which present during pregnancy. Hemangiomata of the spinal cord associat ed with congenital cutaneous vascular lesions of the same metamere have been reported [Cobb, 1915;Doppman, el al., 1969]; however, in most cases these lesions appear to be nevi flammei.…”

“…These three conditions are also states of increasing estrogen levels in the blood. Circumstantial evidence indicates a major role of estrogen in the induction of telangiectasias and in the stimulation of angiomas [Bean, 1958;N ewman, 1958;Smith, 1959;Newquist and Mayfield, 1960;Barter el al., 1963;Cunliffe el al., 1972;Wilkin, 1977], Thus, the unilateral dermatomal distribution of the superficial telangiectasia suggests a nevoid distribution of target end organs [Selmanowitz, 1970] sensitive to estrogens [Wilkin, 1977]. As for the onset of congenital UDST, one would only have to postulate a lower threshold to estrogen in the abnormal target end organs.…”