Sinonasal organising haematoma – a little known entity

Abstract Introduction: Sinonasal organising haematoma is a recently described, rare, benign inflammatory condition, which closely resembles malignancy in its clinical presentation. Objective: To describe the clinical features of organising haematoma and to review the evolution of surgical options successfully used. Methods: A retrospective review of charts of all patients with a histopathological diagnosis of sinonasal organising haematoma was performed. Results: Six (60%) of the 10 patients were male with a mean age of 47.4 years. All patients had unilateral disease with recurrent epistaxis as the presenting symptom. Maxillary sinus was the most commonly involved sinus. There was no history of trauma in any of the patients. Hypertension (80%) was the most commonly associated comorbidity. Contrast-enhanced CT scan of the paranasal sinuses showed heterogeneous sinus opacification with/without bone erosion. Histopathological examination was diagnostic. Complete endoscopic excision was done in all patients resulting in resolution of the disease. Conclusion: Awareness of this relatively new clinical entity and its evaluation and treatment is important for otolaryngologists, maxillofacial surgeons and pathologists alike. Despite the clinical picture of malignancy, histopathological features of benign disease can safely dispel such a diagnosis.

摘要：
引言：鼻窦机化性血肿（sinonasal organising haematoma）是近年被报道的罕见良性炎症性疾病，其临床表现与恶性肿瘤高度相似。
目的：阐述鼻窦机化性血肿的临床特征，并回顾目前已成功应用的手术治疗方案的发展历程。
方法：对所有经组织病理学确诊为鼻窦机化性血肿的患者的病历资料进行回顾性分析。
结果：10例患者中6例为男性（占比60%），平均年龄47.4岁。所有患者均为单侧病变，首发症状均为反复鼻出血。上颌窦是最常受累的鼻旁窦。所有患者均无外伤史。高血压为最常见的合并症（占比80%）。鼻旁窦增强CT（contrast-enhanced CT）扫描显示鼻窦不均匀致密影，可伴或不伴骨质破坏。组织病理学检查可明确诊断。所有患者均接受完全内镜下切除术，术后疾病均得到痊愈。
结论：耳鼻喉科医师、颌面外科医师及病理医师均需对这一相对新兴的临床病种及其诊疗方案有所认知。尽管该疾病的临床表现酷似恶性肿瘤，但其良性的组织病理学特征可安全排除恶性诊断。