Nasal angiomyolipoma: report of two cases and literature review

Abstract

Angiomyolipoma is a hamartomatous lesion, usually of a renal location associated with tuberous sclerosis. Nasosinusal location is extremely rare and can present with nasal obstruction and epistaxis. Two cases of angiomyolipoma of the nasal cavity diagnosed at the Carlos Van Buren Hospital in Valparaíso are presented. Both cases presented as a unilateral nasal mass, and were studied with computed tomography, and treated with an excisional biopsy, with no recurrences during follow-up. Anigiomyolipoma is composed of blood vessels, smooth muscle and adipocytes. There are differences between angiomyolipoma of the kidney versus skin, oral and nasal cavity (mucocutaneous angiomyolipomas). The latter are extremely infrequent, smaller in size, with the presence of lymphoid aggregates, negative for the HMB-45 specific melanoma antigen and without association with tuberous sclerosis. There are few cases reported in the literature of this pathology, so there is little evidence. Clinically, they present with nasal obstruction, recurrent epistaxis, sensation of nasal mass. The preoperative study depends on its extension and may include a computed tomography and/or angiography to identify its irrigation. The definitive diagnosis is pathological. If complete excision is achieved, no recurrences have been reported, so it has an excellent prognosis.