Tohoku J. Exp. Med., 2021 June, 254(2)

Preoperative Endovascular Embolization in an Easily Bleeding Respiratory Epithelial Adenomatoid Hamartoma of the Olfactory Cleft: A Case Report

Jun Suzuki,1 Hiroki Tozuka,1 Tomotaka Hemmi,1 Hiroyuki Ikushima,1 Tomohiko Ishikawa,1 Yohei Morishita,2 Kazuhiro Nomura,3 Mitsuru Sugawara3 and Yukio Katori1

1Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
2Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
3Department of Otolaryngology, Tohoku Kosai Hospital, Sendai, Miyagi, Japan

Respiratory epithelial adenomatoid hamartomas (REAHs) are rare tumors occurring in the nasal cavity and sinuses, and their etiology is unknown. REAH is a relatively recently established lesion and is often misdiagnosed as nasal polyposis or other tumors. Preoperative endovascular embolization for sinonasal tumors is now widely accepted as an effective method to reduce blood loss, soften the tumor, and facilitate surgical procedures. However, to the best of our knowledge, there are no reports of the requirement for preoperative embolization in the management of REAH. Here, we present a 70-year-old man with an easily bleeding REAH of the olfactory cleft, vascularized by branches of the bilateral internal and external carotid arteries. We removed the tumor endoscopically after preoperative embolization of the bilateral sphenopalatine arteries. Histological investigation revealed an intratumoral hemorrhage accompanying the REAH, with no evidence of a residual or recurrent tumor during the last follow-up at 3 months. In conclusion, accurate preoperative diagnosis and proper preoperative interventions such as embolization are needed for safe and adequate treatment of REAHs that have an abundant blood flow.

Key words —— endoscopic endonasal surgery; nasal cavity; olfactory cleft; preoperative embolization; respiratory epithelial adenomatoid hamartoma (REAH)

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Tohoku J. Exp. Med 2021, 254, 107-110.

Correspondence: Jun Suzuki, Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.

e-mail: j_suzuki1212@orl.med.tohoku.ac.jp