Middle Turbinate Vascular Malformation Associated With Angiofibroma Originating From the Nasal Septum: A Case Report

According to the latest classification of vascular lesions, cavernous hemangioma is considered a venous or arteriovenous malformation. The literature has not described the association between vascular malformation of the middle turbinate and angiofibroma of the nasal septum. A 26-year-old female patient with profuse left-sided bleeding and nasal obstruction is presented. She was bleeding from a vascular malformation of the left middle turbinate, and from an angiofibroma, attached to the posterior edge of the nasal septum. The patient also had hypoplasia of the left maxillary sinus and a lack of the septum in the sphenoid sinus. Despite the embolization of the supplier, the patient lost 1.5 L of blood. Although necessary, preoperative embolization is frequently insufficient to prevent significant blood loss during the removal of vascular lesions of the nasal cavity. Vascular malformations of the sinonasal region should be considered in cases of frequent and profuse nosebleeds in patients with hypertrophy of the middle turbinate associated with anatomical variations.