Endoscopic Treatment of Sinonasal Glomangiopericytoma: A Case Report in Light of the Literature

Abstract

A 71-year-old Japanese male patient presented with a rare case of Glomangiopericytoma (GPC) of the left nasal with obstruction. Complete resection with endoscopic surgery was performed. Immunohistochemical staining for smooth muscle actin, β catenin, cyclin D1, vimentin, and factor 13 were helpful in establishing a definitive diagnosis. Extranasal treatment has been traditionally performed for successful management. However, recent advances in endoscopic treatment have enabled complete endoscopic resection of GPC, minimizing morbidity and facilitating subsequent surveillance for recurrence. Endoscopic management should be considered in suitable cases.

Keywords: endoscopic surgery; glomangiopericytoma; nasal obstruction.

Fig. 1.

Preoperative endoscopic photograph of the left nasal cavity occupied by the mass. (* tumor, # middle turbinate, + nasal septum)

Fig. 2.

Preoperative coronal CT scan of the paranasal sinuses showed a low-density, homogeneous lesion occupying the left nasal cavity (A). Preoperative coronal and axial MRI showed that the tumor had low signal intensity in the T1-weighted image and low to iso signal intensity in the T2-weighted image (B–D). CT, computed tomography; MRI, magnetic resonance imaging.

Fig. 3.

Pathological examination showed (A) uniform proliferation of oval to short spindle-shaped cells with fibrous edematous tissue, and hyalinization (hematoxylin and eosin staining, Bar = 100 μm). (B) From the same area, cone-shaped cells positive for anti–smooth muscle actin antibody can be seen (Bar = 100 μm). (C) Cone-shaped cells also positive for anti-vimentin antibody can be seen (Bar = 100 μm). (D–F) Cone-shaped cells are also positive for (D) beta-catenin, (E) factor 13a, and (F) cyclin D1 (Bar = 100 μm).