Management of Sinonasal Hemangiopericytomas: A Systematic Review

Introduction: Although hemangiopericytomas are typically found in soft tissue, they are rarely found in the sinonasal tract. Cases of these sinonasal hemangiopericytomas have been reported mostly through case studies, and optimal treatment is considered surgical excision. With the wider use of endoscopic methods, an updated systematic review of the treatment of these cases is warranted.

Methods: Cases were identified using broad MEDLINE and PubMed searches. Relevant studies were identified, and data were extracted regarding patient demographics, presenting symptoms, tumor characteristics, treatment, and outcomes.

Results: For the study, 128 cases were collected from 56 articles, consisting of case reports and series. The most common presenting symptoms were epistaxis, nasal obstruction, and facial pain/swelling/pressure. Computed tomography and x-rays were the most common modes of imaging during diagnosis and operative planning. In most cases, the tumor occupied more than one distinct location in the sinonasal tract at initial presentation. Surgical resection was the mainstay of treatment in 125 of the 128 cases (97.7%), through either open resection or endoscopic techniques. Surgical removal resulted in no recurrence in 78.9% of the cases. The use of endoscopic techniques increased significantly in the past decade.

Conclusion: Surgical management remains the mainstay of treatment for hemangiopericytomas. Endoscopic resection of these lesions has significantly increased over the last decades and has become a safe, viable, and preferred alternative to open resection in selected patients.