Advertisement

Nasal Framework Reconstruction in Patient with Eosinophilic Angiocentric Fibrosis

  • Amir Arvin Sazgar
  • Sahand Kia
  • Armin AkbariEmail author
Clinical Report

Abstract

Eosinophilic angiocentric Fibrosis (EAF) is a rare condition involving the sinonasal tract and nasal septum which is mostly considered as a benign condition. EAF could present with progressive nasal obstruction as its most common symptom. In this case report, we try to report a case of middle aged man with nasal septum tumor-link lesion which was diagnosed with EAF. A 45 years old man presented with complete nasal obstruction who described a growing nasal cavity mass for over 6 months. Anterior rhinoscopy revealed bilateral mass with a smooth surface on the nasal septum and mass protruded into both nasal cavities. CT scan showed a 28 × 18 mm soft tissue mass in nasal cavity mostly in right side with erosion of right maxillary alveolar ridge. Microscopic examination of a biopsy taken from the mass showed dense infiltration of inflammatory cells rich in eosinophils as well as perivascular condensation of fibrotic bundles creating onion-skin appearance was noted. The patient went under surgical ablation of the tumor and has been followed up every 2–3 month for about 1 year and there was no evidence of recurrent disease. The complete surgical excision may eradicate the allergic manifestations in the EAF patients and cartilage graft such as rib graft seems to be safe if the reconstruction is needed. It is important to prevent tumor from recurrence by totally resecting the involved tissues.

Keywords

Eosinophilic angiocentric fibrosis (EAF) Nasal septum Nasal framework reconstruction 

Notes

Acknowledgments

We gratefully acknowledge the dedicated efforts of the investigators, the coordinators, and the volunteer patient who participated in this study.

Funding

Although there was no funding for the current manuscript, this study was performed by the Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Authors’ contributions

Amir Arvin Sazgar: Scientific supervision of the manuscript, final edition and confirmation of the manuscript. Sahand Kia: Taking the History from the patient, monitoring and recording the course of the case, revising the final manuscript. Armin Akbari: writing the final manuscript, confirming the final manuscript, submitting the final manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors have indicated that they have no conflicts of interests regarding the content of this article.

Availability of data and materials

Availability of data and material is not applicable for these manuscripts as it is a Case report. Although the authors consider that every gathered information on this case is present in the current study, the corresponding author will be providing responses for any questions asked on this matter.

Consent for publication

All the authors have read and approved this manuscript, giving their permission for the current submission.

Ethics approval and consent to participate

The patient in this case report was informed about the rare condition and its academic value giving an informed consent for the current publication both before and after the delivery of the current manuscript. We, herein, want to state that all of the treatments and investigations were performed under the latest guidelines and in agreement with the recommendations of the Ethics Committee of Tehran University of Medical Sciences and in accordance with Declaration of Helsinki as a statement of ethical principles for medical research involving human subjects. This case study was approved by ethics committee of Tehran University of Medical Sciences (ethics code 9521435).

References

  1. 1.
    NINDS NET-PD Investigators (2008) A pilot clinical trial of creatine and minocycline in early Parkinson disease: 18-month results. Clin Neuropharmacol 31(3):141–150.  https://doi.org/10.1097/wnf.0b013e3181342f32
  2. 2.
    Roberts P, McCann B (1997) Eosinophilic angiocentric fibrosis of the upper respiratory tract: a postscript. Histopathology 31(4):385PubMedGoogle Scholar
  3. 3.
    Roberts P, McCann B (1985) Eosinophilic angiocentric fibrosis of the upper respiratory tract: a mucosal variant of granuloma faciale? A report of three cases. Histopathology 9(11):1217–1225CrossRefGoogle Scholar
  4. 4.
    Rimmer J, Andrews P, Lund V (2014) Eosinophilic angiocentric fibrosis of the nose and sinuses. J Laryngol Otol 128(12):1071–1077CrossRefGoogle Scholar
  5. 5.
    Ferry JA, Deshpande V (eds) (2012) IgG4-related disease in the head and neck. Seminars in Diagnostic Pathology ElsevierGoogle Scholar
  6. 6.
    Deshpande V, Khosroshahi A, Nielsen GP, Hamilos DL, Stone JH (2011) Eosinophilic angiocentric fibrosis is a form of IgG4-related systemic disease. Am J Surg Pathol 35(5):701–706CrossRefGoogle Scholar
  7. 7.
    Fageeh NA, Mai KT, Odell PF (1996) Eosinophilic angiocentric fibrosis of the subglottic region of the larynx and upper trachea. J Otolaryngol 25(4):276–278PubMedGoogle Scholar
  8. 8.
    Altemani AM, Pilch BZ, Sakano E, Altemani JM (1997) Eosinophilic angiocentric fibrosis of the nasal cavity. Mod Pathol 10(4):391–393PubMedGoogle Scholar
  9. 9.
    Keogh I, O’Connell R, Hynes S, Lang J (2017) Eosinophilic angiocentric fibrosis as a stenosing lesion in the subglottis. Case Rep Otolaryngol.  https://doi.org/10.1155/2017/2381786 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Tabaee A, Zadeh MH, Proytcheva M, LaBruna A (2003) Eosinophilic angiocentric fibrosis. J Laryngol Otol 117(05):410–413CrossRefGoogle Scholar
  11. 11.
    Holmes DK, Panje WR (1983) Intranasal granuloma faciale. Am J Otolaryngol 4(3):184–186CrossRefGoogle Scholar
  12. 12.
    Burns B, Roberts P, De Carpentier J, Zarod A (2001) Eosinophilic angiocentric fibrosis affecting the nasal cavity. A mucosal variant of the skin lesion granuloma faciale. J Laryngol Otol 115(03):223–226CrossRefGoogle Scholar
  13. 13.
    Sunde J, Alexander KA, Reddy VV, Woodworth BA (2010) Intranasal eosinophilic angiocentric fibrosis: a case report and review. Head Neck Pathol 4(3):246–248CrossRefGoogle Scholar
  14. 14.
    Valenzuela AA, Whitehead KJ, Brown I, Sullivan TJ (2006) Eosinophilic angiogentric fibrosis: an unusual entity producing complete lacrimal duct obstruction. Orbit. 25(2):159–161CrossRefGoogle Scholar
  15. 15.
    Jain R, Robblee JV, O’Sullivan-Mejia E, Lea J, Heller A, Faquin WC et al (2008) Sinonasal eosinophilic angiocentric fibrosis: a report of four cases and review of literature. Head Neck Pathol 2(4):309–315CrossRefGoogle Scholar
  16. 16.
    Narayan J, Douglas-Jones AG (2005) Eosinophilic angiocentric fibrosis and granuloma faciale: analysis of cellular infiltrate and review of literature. Ann Otol Rhinol Laryngol 114(1):35–42CrossRefGoogle Scholar
  17. 17.
    Yang B, Wang Y, Wang X, Wang Z (2011) Nasal cavity eosinophilic angiocentric fibrosis: CT and MR imaging findings. Am J Neuroradiol 32(11):2149–2153CrossRefGoogle Scholar
  18. 18.
    Thompson LD, Heffner DK (2001) Sinonasal tract Eosinophilic angiocentric fibrosis. Am J Clin Pathol 115(2):243–248CrossRefGoogle Scholar
  19. 19.
    Nogueira CRA, Damasceno FM, de Aquino-Neto MR, de Andrade GM, Fontenele JB, de Medeiros TA et al (2011) Doxycycline protects against pilocarpine-induced convulsions in rats, through its antioxidant effect and modulation of brain amino acids. Pharmacol Biochem Behav 98(4):525–532CrossRefGoogle Scholar
  20. 20.
    Nguyen DB, Alex JC, Calhoun B (2004) Eosinophilic angiocentric fibrosis in a patient with nasal obstruction. ENT. Ear Nose Throat J 83(3):183–184CrossRefGoogle Scholar
  21. 21.
    Önder S, Sungur A (2004) Eosinophilic angiocentric fibrosis: an unusual entity of the sinonasal tract. Arch Pathol Lab Med 128(1):90–91PubMedGoogle Scholar
  22. 22.
    Fang CH, Mady LJ, Mirani NM, Baredes S, Eloy JA (2014) Sinonasal eosinophilic angiocentric fibrosis: a systematic review. Int Forum Allergy Rhinol 4:745–752CrossRefGoogle Scholar
  23. 23.
    Kraft SM, Patel N, Sauer D, Hamilton B, Schindler JS (2013) Eosinophilic angiocentric fibrosis of the subglottis. Otolaryngology 149(2):P205–PCrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Otorhinolaryngology Research CenterTehran University of Medical SciencesTehranIran

Personalised recommendations