Purpose:
Sinonasal glomangiopericytoma is found in less than 0.1% of all
sinonasal tumors. While this tumor may erode bone, it has an
excellent prognosis. While treatment is surgical, knowledge that
it can recur in 16% of patients should be known so as to prevent
misclassification as a more aggressive neoplasm. Proper
radiologic-pathologic correlation may provide reassurance to the
operating ENT/neurosurgeon, and prevent the medical
oncologist and radiation oncologist from inappropriately
administering chemotherapy and radiation therapy. Sinonasal
glomangiopericytoma is also presented because it is not wellrepresented
in the radiology literature.
Case Report:
A male patient in his early 60's with a history of atrial fibrillation
and prior transient ischemic attack presented to the emergency
room with new onset left arm and leg weakness/paresthesia.
The patient had no prior history of cancer or any sinonasal issue.
The patient quit smoking over 30 years ago, and only has
occasional alcoholic beverages. While there was no stroke or
acute arterial pathology on CTA, a mass was discovered in the
left ethmoid sinus (imaging details in Image Findings section of
abstract). The decision was made to surgically excise the tumor
with a collaborative operation by ENT and neurosurgery. While
there was osseous erosion, & the dura remained without tumor
invasion. Pathologists confirmed the diagnosis of sinonasal
glomangiopericytoma by microscopic appearance and staining.
No chemotherapy or radiation therapy is planned because of the
improved 10-year survival without these adjuvant treatments.
The patient is doing well post-operatively.
Image Findings:
CT without contrast demonstrates a mass isodense to soft
tissues, & without calcification. CTA demonstrates an arterially
enhancing 2.5 cm mass eroding the ethmoid cribriform plate and
left lateral lamella. However, there is no adjacent periosteal
reaction or hyperostosis. The mass appears to protrude through
the bone into the anterior cranial fossa. The mass is isointense
to brain parenchyma on T1 and T2 sequences, with no restricted
diffusion, and homogenous contrast enhancement. There is no
dural enhancement or dural thickening. There was only minimal
mass effect, and no adjacent cerebral edema.
Summary:
Sinonasal glomangiopericytoma is very rare amongst sinonasal
tumors. Knowledge of the imaging characteristics will allow for
proper radiologic-pathologic correlation, resulting in a clinical
course that is distinct from other sinonasal tumors.
References:
1. Park ES, Kim J, Jun SY. Characteristics and prognosis of glomangiopericytomas: A
systematic review. Head Neck. 2017 Sep;39(9):1897-1909.
2. Sharma N, Mandlik D, Patel P, Patel P, Joshipura A, Patel M, Mankiwala S, Vatsyayan
A, Dubey T, Sanghvi K, Shah D, Kanhere S, Talati S, Patel K. A rare case of sinonasal
glomangiopericytoma post operative accidental diagnosis and management-A case
report. Int J Surg Case Rep. 2019;62:54-57.
3. Saito Y, Ohta N, Konosu-Fukaya S, Shoji F, Suzuki T, Noguchi N, Kakuta R, Ikeda R,
Yamazaki M, Kusano Y, Ishida Y, Satake M, Ise K, Kagaya Y, Tamura R, Murakami K,
Nakamura Y. Yonago. Endoscopic Treatment of Sinonasal Glomangiopericytoma: A
Case Report in Light of the Literature. Acta Med. 2019 Jun 20;62(2):236-239.
4. Kono M, Bandoh N, Matsuoka R, Goto T, Akahane T, Kato Y, Nakano H, Yamaguchi T,
Harabuchi Y, Nishihara H. Glomangiopericytoma of the Nasal Cavity with CTNNB1
p.S37C Mutation: A Case Report and Literature Review. Head Neck Pathol. 2019
Sep;13(3):298-303.
5. Monisha Dandekar and Jonathan B. McHugh (2010) Sinonasal Glomangiopericytoma:
Case Report With Emphasis on the Differential Diagnosis. Archives of Pathology &
Laboratory Medicine: October 2010, Vol. 134, No. 10, pp. 1444-1449.

Sinonasal Glomangiopericytoma: Imaging Appearance & Update on a Rare Sinonasal Neoplasm

[Virtual Conference Page](https://event.vconferenceonline.com/microsite/html/login.aspx?id=1551&rlp=1)

[ASNR Website] (https://www.asnr.org//annualmeeting)

[Educational Exhibits](https://www.morressier.com/event/asnr2020exhibit/5e5d0be000701ceba4a26941)