International Journal of Otorhinolaryngology and Head and Neck Surgery | April-June 2017 | Vol 3 | Issue 2 Page 423 International Journal of Otorhinolaryngology and Head and Neck Surgery Panbude SN et al. Int J Otorhinolaryngol Head Neck Surg. 2017 Apr;3(2):423-426 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 Case Report Cavernous hemangioma of the nasal cavity: mimicking as the inverted papilloma Sushil Natthuji Panbude, Amrita Harish Guha*, Abhishek Mahajan, Nilesh Pandurang Sable, Supreeta Arya INTRODUCTION Haemangiomas are benign vascular tumours, which originate in the skin, mucosa and deep structures such as bones, muscles and glands. Exact etiopathogenesis of haemangiomas formation is not known, although they are divided into two types depending on the dominant vessel size at microscopy into capillary and cavernous types. When these neoplasms arise in the nasal cavity, they are predominantly capillary and are found to arise from the nasal septum and are more common in the children. On the other hand, cavernous haemangiomas are more likely to be found on the lateral wall of the nasal cavity and are more commonly seen in elderly. 1 In the largest study of nasal haemangiomas by Osborn in 1959 which reviewed 51 patients with nasal haemangiomas over an 11-year period, only two were of the cavernous variety. 2 We have presented a rare case cavernous haemangiomas arising from the mucosa of the middle nasal meatus, in a 37- year-old male mimicking as an inverted papilloma. CASE REPORT A 37 year old male patient presented with intermittent swelling of the left side of face and epistaxis since 1.5 years. Anterior rhinoscopy revealed a large soft tissue mass almost completely filling in the left nasal cavity, with active mucoid discharge and minimal blood clots. A contrast enhanced MR scan was done which revealed a well-defined non bone erosive mass within and limited to ABSTRACT Cavernous hemangioma of the nasal cavity is extremely rare with only case reports in the literature highlighting the imaging findings on CT and MRI. Haemangioma are benign vascular tumours, which originate in the skin, mucosa and deep structures such as bones, muscles and glands. Exact etiopathogenesis of the haemangioma is not known, although they are divided into two types depending on the dominant vessel size at microscopy, capillary and cavernous. When these neoplasms arise in the nasal cavity, they are predominantly capillary and are found to arise from the nasal septum and are more common in the children. On the other hand, Cavernous haemangiomas are more likely to be found on the lateral wall of the nasal cavity and are more commonly seen in elderly. Also, inverted pappiloma also more commonly arise from the lateral wall of the nasal cavity, from the middle turbinate and also has the same demographics as the cavernous hemangioma. So, the distinction between the two should be carefully made based on the imaging findings so as to give the appropriate treatment to the patient. We have presented a rare case cavernous haemangioma arising from the mucosa of the middle nasal meatus, in a 37-year-old male which is mimicking as an inverted pappiloma based on the imaging features; however on histopathology proved to be cavernous hemangioma and also on the multimodal imaging that helps in early diagnosis and advocating appropriate and timely treatment. Keywords: Cavernous hemangioma, CT and MRI, Histopathology, Inverted papilloma Department of Radiodiagnosis, Tata memorial Hospital, Mumbai, Maharashtra, India Received: 24 December 2016 Accepted: 03 February 2017 *Correspondence: Dr. Amrita Harish Guha, E-mail: amritaguha85@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20171204