鼻背皮下血管瘤经鼻整形术治疗：文献综述

文献信息

中文摘要

血管异常，包括血流缓慢的血管瘤，可发生在身体任何部位。它们多为孤立性病变，且更常见于女性。这种畸形不会自行消退。一种罕见的类型，称为皮下血管瘤，生长具有侵袭性，切除后偶可复发。在本报告中，我们介绍一例44岁女性，因7年前鼻部外伤后出现缓慢生长、疼痛的鼻部隆起。除疼痛外，她否认任何相关症状。体格检查发现鼻背处可触及一约1 cm×0.5 cm的柔软、不可移动的肿块。有轻度压痛，皮肤外观正常。CT扫描影像学检查显示左侧鼻骨皮质破坏性改变，并可见软组织密度影位于左鼻腔前部，紧邻鼻中隔前部。此外，MRI研究显示鼻梁下方T1 FSE图像上边界清晰、圆形的等信号病变，T2 FSE图像上呈高信号。最终，患者接受了开放式鼻整形术。根据组织病理学结果，可见反应性骨伴骨骼肌纤维、纤维化及扩张的血管通道。未见异型性、核分裂及坏死。患者术后恢复良好，无并发症，并安排常规门诊随访。

英文摘要

Vascular anomalies, including hemangiomas, which have slow blood flow, can develop anywhere on the body. They are mostly isolated lesions and are more common in women. The deformity does not regress on its own. A rare variety, known as subcutaneous hemangioma, grows aggressively and occasionally recurs after excision. In this report, we present a case of a 44-year-old female who experienced a slowly growing, painful nasal hump as a result of nasal trauma she sustained 7 years ago. She denied any associated symptoms apart from pain. Physical examination revealed a palpable, soft, nonmobile mass measuring ∼1 cm by 0.5 cm over the nasal dorsum. There was mild tenderness, and the skin appeared normal. Imaging workup with a CT scan showed a destructive process in the cortex of the left nasal bone, with soft-tissue density noted in the anterior left nasal cavity abutting the anterior nasal septum. Furthermore, an MRI study showed a well-defined, rounded, isointense lesion on T1 FSE images under the nasal bridge and hyperintense on T2 FSE images. Ultimately, the patient underwent open rhinoplasty. According to the histopathology results, there was reactive bone with skeletal muscle fibers, fibrosis, and dilated vascular channels. Atypia, mitosis, and necrosis were not present. The patient was doing well postoperatively with no complications and was scheduled for routine clinic follow-ups.