Paranasal sinus angiosarcoma with facial paralysis as a novel manifestation: a case report and literature review

Abstract

Background Paranasal sinus angiosarcoma is an uncommon malignancy, with only a few reported cases worldwide. Although it exhibits multiple symptoms, facial paralysis has not been previously documented as a noticeable presentation. Case Presentation In this case, we report a 40-year-old male who presented with facial numbness and pain for one month, weakness of his facial muscles for 15 days, and recurrent right epistaxis for 1 year. He had a history of nasal inflammatory polyps with chronic sinusitis. Computed tomography and magnetic resonance imaging showed space-occupying lesions in the right nasal cavity and maxillary sinus, with bone destruction occurring in the sinus wall and turbinate. This patient then underwent endoscopic surgery. According to the histopathological and immunohistochemical results, he was eventually diagnosed with paranasal sinus angiosarcoma in April 2021. To date, this patient has not initiated any radiotherapy or chemotherapy and has survived with lymphatic metastasis for at least 3 years. Conclusions This manuscript suggests that paranasal sinus angiosarcoma can present with facial paralysis. Moreover, pathological and immunohistochemical tests are still vital for diagnosing paranasal sinus angiosarcoma and differential diagnosis. Additionally, regular follow-up is crucial for patients with paranasal sinus angiosarcoma, enabling monitoring of recurrence, metastasis, and recovery while contributing valuable clinical data to understanding this rare disease and associated research endeavours.

Angiosarcoma of the Maxillary Sinus: A Case Report

“…Nasal angiosarcomas are observed as lesions with irregular and ulcerated margins [ 5 ]. In the study by Chai et al [ 2 ], a 40-year-old male presented with similar symptoms to this case, along with face numbness. Magnetic resonance imaging and computed tomography are found to be helpful in the diagnosis of these lesions, which can be further aided by immunohistochemical staining [ 3 , 4 ].…”

“…Angiosarcoma of the nasal sinus is a rare presentation in paranasal and nasal sinuses, with a small incidence of approximately 0.1% [3]. Diagnosis of nasal angiosarcoma remains a diagnostic challenge, attributed to its low incidence and mild symptoms in the initial stage, which might result in a poor prognosis [2]. Clinical presentation of nasal sarcomas is usually associated with airway obstruction, facial swelling, and proptosis with or without epistaxis [4].…”

“…Angiosarcomas are aggressive malignancies arising from the mesenchymal cells with more than 50 subtypes of histopathological variants [ 1 ]. Angiosarcomas are vascular phenotypic malignant neoplasms with endothelial-like characteristics in their tumor cells, with high frequency in the neck and the head region in patients without any medical history [ 2 ]. Angiosarcoma of the nasal sinus is a rare presentation in paranasal and nasal sinuses, with a small incidence of approximately 0.1% [ 3 ].…”