IntroductionAngioleiomyomas (AL) of the nasal cavity and paranasal sinuses are extremely rare benign tumors, representing less than 1% of all leiomyomas in the human body [1]. Common sites are the uterus and the gastrointestinal tract [2]. It is very rare into the nasal-paranasal cavities (only fifteen cases are reported in the literature) due to the paucity of smooth muscle tissue in this site [3].Because of its rarity, the literature of AL in the nasal cavity and paranasal sinus is reviewed and the management is discussed. Case ReportA-40-year-old man was admitted to the Radiology Department of our institution for the evaluation of a palpable tender mass protruding at the right medial canthus. The patient had observed a slow growth of this mass, associated with progressive reduction of smell, right nasal obstruction an omolateral recurrent self limited nasal bleeding.Ultrasound examination revealed a lobulated solid tissue with a rich homogeneous vascularity at the color-doppler. Nasal fibroendoscopic examination revealed an easily bleeding mass occupying the right nasal cavity completely. MRI confirmed a solid mass (38 x 28 x 28 mm) centered at the level of the right nasal cavity and anterior ethmoid cells, crossing the midline, with lateral involvement of the medial orbital wall and dislocation of the right peri-bulbar fat with cranial extension. Disruption of the right paramedian cortical bone of the anterior cranial fossa due to bone remodelling was observed at the contextual CT examination with coronal reformatted images (Figure 1). After gadolinium-containing contrast agent (Omniscan) intravenous administration, the lesion showed intense and homogeneous enhancement with tiny hypointense spots in the context of the lesion. The pathologic study revealed fragments of nasal mucosa with aspects of hyperaemia and mild inflammation.Transnasal surgical resection was planned and performed as follows by S.F. through a combined use of endoscopy and microscopy approach. Cottonoids soaked in oxymetazoline solution were positioned in the nasal cavity and left in place for ten minutes. One percent lidocaine Abstract Background: Angioleiomyomas of the paranasal sinuses are extremely rare benign tumors, representing less than 1% of all leiomyomas in the human body.
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