A giant pyogenic granuloma in the nasal cavity caused by nasal packing

Abstract

Pyogenic granuloma is a benign, rapidly growing hemorrhagic lesion of unknown origin. This disorder, however, is obscure to many rhinologists, because the nose is a relatively rare location for the lesion. In the practice of otorhinolaryngology, nasal packing is a very common procedure for nasal bleeding and postoperative hemostasis. However, few pyogenic granulomas occurring from nasal packing have been reported in the literature. A 56-year-old man underwent nasal packing with vaseline gauze because of nasal bleeding. Two months later, a dark brown nasal tumor was found in his nasal cavity. He underwent endoscopic endonasal removal of the tumor. The pathology result showed a pyogenic granuloma. This is the third case recorded in the literature of a confirmed pyogenic granuloma occuring as a complication of nasal packing. This uncommon lesion should be considered in the differential diagnosis of a rapidly growing hemorrhagic lesion within the nasal fossa.

Routine and Dynamic MR Imaging Study of Lobular Capillary Hemangioma of the Nasal Cavity with Comparison to Inverting Papilloma

“…The ulcerative area is composed of neutrophilic infiltrates and irregular dilation of blood vessels, which may undergo secondary nonspecific changes, including stromal edema, inflammation, and a granulation tissue reaction. 4,5 Nasal LCH may develop at any age but is more frequent in the third and fourth decades and in females, 3,4,7,8,11 though our study showed a slight male predominance. LCH usually manifests as recurrent unilateral epistaxis, nasal obstruction, and purulent nasal discharge.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] LCH is now accepted as the preferred nomenclature because it best represents the true nature of the lesion, which consists of capillaries arranged in lobules and separated by an edematous fibroblastic stroma infiltrated by inflammatory cells. 1,4,12 LCH usually originates from the vascular tissue of the skin, mucosa, muscle, gland, and bone.…”

Capillary Hemangioma of the Lateral Nasal Wall: An Unusual Location

“…When it is seen in the nasal cavity, LCH mostly locates on the anterior portion of nasal septum (Little's area), less frequently on anterior side of inferior turbinate. 3,4 In this case LCH was arising from the lateral nasal wall of left nasal cavity. The most common presenting symptom of LCH of the nasal cavity is bleeding and/or obstructive symptoms.…”

Lobular Capillary Hemangioma of Nasal Septum - A rare presentation

“…There is no intercommunication of vascular spaces or cytological atypia. [1][2] Usually clinical findings, imaging methods and biopsy lead to diagnosis. The advent of endoscopy has eased the approach for diagnosis and treatment of such nasal masses which vary in site, size and degree of vasculature.…”

“…In the nasal cavity, it commonly locates on the anterior portion of nasal septum (Little's area), followed by lateral wall, vestibule and middle turbinates. [1] [2] LCH occurs at all ages, more often in the third decade, and is commoner in females. In the pediatric age group, it commonly affects males.…”