Angioleiomyoma of the nasal cavity

Abstract

Angioleiomyoma is a rare benign tumor in the nasal cavity. There are very few reports in literature. A 34 year old male presented with left sided nasal obstruction and epistaxis. Clinical evaluation revealed a lesion replacing the anterior two-third of the Left inferior turbinate. An endoscopic excision under hypotensive anesthesia was performed. Histopathology confirmed a diagnosis of Angioleiomyoma. The cause and site of origin of angioleiomyomas when they arise from the inferior turbinate remains unclear. We review the literature available on nasal angioleiomyoma. When limited to the nasal cavity endoscopic excision is the treatment of choice.

Recurrent angioleiomyoma of the middle turbinate

“…Leiomyomas constitute approximately 1% of all benign tumours in the human body 2 3. The most common sites of occurrence are the uterus which accounts for 95% of all leiomyomas.…”

“…Less common sites are the skin (3%) and gastrointestinal tract (1%). Only 0.5% of leiomyomas occur at other sites which include the head and neck region 1 3 4. Hachisuga5 reported 48 cases of leiomyoma in the head and neck which included five cases in the nose and paranasal sinuses.…”

“…They are: (1) Presence of undifferentiated mesenchymal aberrations (2) Presence of smooth muscle in turbinal blood vessels (3) Presence of smooth muscle in vestibular erector pili and sweat glands 3 4 7…”

ANGIOLEIOMYOMA OF THE NASAL CAVITY An Unusual Tumor.

“…Forty nine additional cases have been reported in the Japanese literature. 9 The origin of angioleiomyoma of the nasal cavity is uncertain, partly due to the scarcity of smooth muscle in the nasal cavity. Three hypotheses have been proposed for the origin of smooth muscle tumors in the nasal cavity: from aberrant undifferentiated mesenchymal cells; from elements of smooth muscle in the walls of blood vessels and of piloerector muscles; or from both previous hypotheses, simultaneously.…”

“…3,14 The literature shows a prevalence of angioleiomyomas of the nasal cavity in female patients (in a 2:1 ratio between females and males) between the fourth and sixth decades of life, and affecting mainly the inferior nasal conchae. 9,11 These angioleiomyomas develop in the mucosa of the nasal cavity as single solid small cutaneous masses. They can be painful or not and can expand.…”