Giant Arteriovenous Hemangioma (Cirsoid Aneurysm) of the Nose

Abstract

We describe a 97-year-old woman who presented to our clinic with an unusually large pendulous asymptomatic soft tumor on the left side of her nose. History revealed a 40-year course, with accelerated growth in the last 9 years. Histology of this 7 x 3-cm large tumor revealed vascular structures composed of densely aggregated thick- and thin-walled vessels, separated by fibrous tissue. These features are characteristic for an arteriovenous hemangioma, also called cirsoid aneurysm. The distal part of the tumor showed nearly total fibrosis and at the proximal end of the tumor signs of incipient basal cell carcinoma were observed. In spite of the accelerated growth, unusual size, and the presence of a basal cell carcinoma at the base of this tumor, giant cirsoid aneurysms appear to be of a benign nature and thus conservative, nonradical surgical treatment can be performed. The tumor was removed by argon laser surgery with excellent results and no sign of recurrence after 1 year.

Acquired arteriovenous hemangioma on the nose of a middle‐aged man: A case report

“…Till now, few cases of arteriovenous hemangioma have been reported. A giant arteriovenous hemangioma on the nose of a 97‐year‐old woman was reported in 1989 that was treated with argon laser with no recurrence after 1 year 5 . Kim et al reported a case of arteriovenous hemangioma on the ear lobe in the year 2015 4 .…”

“…Arteriovenous hemangioma was first reported by Biberstein and Jessner but later, Enzinger and Weiss divided it into superficial and deep 2,3 . Superficial arteriovenous hemangiomas most commonly develop in the head and neck region, including the lips, the oral cavity, the perioral skin, the nasal cavity, and the eyelids 4,5 . Deep arteriovenous hemangioma can occur so close to skin and is regarded as a malformation.…”

Completely Isolated Arteriovenous Hemangioma in the Tongue

“…Furthermore, this case was histologically determined to be an arteriovenous hemangioma, which is a collection of thick-walled blood vessels with the combined structural characteristics of arteries and of veins. Arteriovenous hemangiomas have been reported as infrequently encountered lesions, but most commonly arise in the head and neck, particularly in the lip, perioral skin, nose, and eyelids (4,10,11 (4). On the other hand, hemangiomas as well as arteriovenous hemangiomas are normally unencapsulated masses of blood vessels (3).…”

Cirsoid aneurysm: a clinicopathological reminder

“…Diagnosis is confirmed by biopsy and histological analysis displaying densely packed blood vessels surrounded by fibrous tissue …”

“…In spite of their potential for accelerated growth and unusual size, CAs are of benign nature. They comprise a type of AV malformation that arises within the subcutaneous layer from multiple pathological anastomoses between feeding arterioles and draining venules, without an intervening capillary bed . These connections result in high‐flow arterial blood divergence into the low‐pressure venous circulation, which leads to regional vessel dilation.…”