Endoscopic Resection of a Rare Case of Fronto-ethmoidal Glomangiopericytoma: A Case Report

Sara Costa Gomes, Eduardo Oliveira Machado da Silva

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Abstract

We report a case of a 58-year-old man with a history of nasal obstruction and recurrent epistaxis who underwent videonasolaryngoscopy after 9 months of symptoms. The first images showed a hyperemic mass affecting the left middle turbinate up to the nasal cleft. Computed tomography described a mass with an expansive effect occupying the entire left frontal sinus and most of the left ethmoid cells, widening the frontal sinus drainage path, and creating a continuity break of the cribriform plate, the left papyraceous lamina, and the upper-third of the nasal septum. Magnetic resonance imaging suggested T1-isointensity and T2-hyperintensity, intense contrast uptake, and no involvement of meningeal or brain tissues. The patient underwent extended endoscopic surgery without previous endovascular embolization or adjuvant therapies. A contralateral inferior turbinate graft was applied over the cribriform plate. Histopathological examination suggested glomangiopericytoma (GPC), and immunohistochemistry confirmed the diagnosis with positive beta-catenin, smooth muscle actin, and cyclin D1. The patient presented no nasal symptoms up to a 9-month follow-up. Nasal endoscopy showed no tumor recurrence signal. Although fronto-ethmoidal GPC is a rare tumor and presents challenging surgical access, it can be safely excised by endoscopic surgery. However, careful short- and long-term endoscopic follow-ups remain necessary to prevent postoperative complications and maintain surveillance of recurrences.
Original languageEnglish
Number of pages43
JournalENT Updates
Volume14
Issue number2
DOIs
Publication statusPublished - Aug 2024

Keywords

  • Endoscopic sinus surgery
  • Epistaxis
  • Glomangiopericytoma
  • Rare diseases
  • Sinusitis

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