Hemorrhagic and Hypervascular Sinonasal Masses: A Review

Sinonasal masses are uncommon and can be challenging to evaluate. Hemorrhage and hypervascularity in association with sinonasal masses may allow radiologists to narrow the differential diagnosis and begin planning further work-up and treatment. Localizing abnormal blood vessels in hypervascular masses may also help to avoid complications related to biopsy and/or surgery. The purpose of this article is to review the imaging and histopathologic features of hemorrhagic and hypervascular sinonasal masses, including sinonasal organized hematoma, lobular capillary hemangioma, cholesterol granuloma, reparative giant cell granuloma, juvenile nasopharyngeal angiofibroma, rhabdomyosarcoma, hemangiopericytoma, hemangioma, sinonasal mucosal melanoma, and metastases. In this article, we present CT and MR imaging algorithms for arriving at a diagnosis and provide a differential diagnosis for sinonasal lesions that mimick hemorrhagic and/or hypervascular masses.

Learning Objective: Review the clinical and demographic features of hemorrhagic and hypervascular sinonasal masses, along with their imaging features.