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Nayani D, Pitale Ashok RK, Loka SR, Jacob AS, Maley S. Breaking New Ground: Unraveling Sinonasal Hemangiopericytoma Through a Rare Case Series on Endoscopic Excision and Postoperative Monitoring. Indian J Otolaryngol Head Neck Surg 2024; 76:3369-3373. [PMID: 39130240 PMCID: PMC11306661 DOI: 10.1007/s12070-024-04692-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/04/2024] [Indexed: 08/13/2024] Open
Abstract
Hemangiopericytoma is a rare vascular neoplasm derived from pericytes, with uncertain malignant potential. It mainly occurs in the retroperitoneum and lower extremities, with a lower incidence in the head and neck region and nasal cavity. Diagnosis is aided by histopathological examination and immunohistochemistry. Surgical excision is the preferred treatment, with different approaches depending on tumour size. Endoscopic excision is suitable for small tumours, while larger ones may require external approaches. The recurrence rate is approximately 25%, emphasizing the importance of long-term follow-up. Our study aims to discuss a rare series of sinonasal hemangiopericytoma cases, their clinical presentation, and their management. In this study, we are discussing the prospective study of six cases of sinonasal hemangiopericytoma that were presented to a tertiary hospital, from June 2017 to June 2023, with complaints of nasal obstruction and bleeding episodes. They were assessed with a detailed history, blood investigations, radiological investigations, and diagnostic nasal examination, and underwent endoscopic surgical excision of the nasal mass, with the diagnosis confirmed by histopathological examination and immunohistochemistry. All cases were followed up for 1 year postoperatively, except one case which missed follow-up after 6 months and with no postoperative complications and recurrences. All six cases came with complaints of nasal obstruction and bleeding from the nasal cavity. All six cases underwent endoscopic surgical excision of the tumour and were followed for 1 year in five cases; one case missed follow-up after 6 months of postoperative follow-up, but no recurrence was noted in all the cases. For small-sized hemangiopericytoma tumours, endoscopic excision offers benefits such as improved visualization, easy resection, preservation of the normal anatomical structure, and maintenance of physiological function in the sinonasal cavities. With a recurrence rate of approximately 25%, surgical excision and long-term follow-up play essential roles in successful tumour management.
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Affiliation(s)
- Divya Nayani
- Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No 5-1-174, Opposite State Bank of India Head Office, Bank Street Road, Koti, Hyderabad, 500095 India
| | - Rahul Kumar Pitale Ashok
- Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No 5-1-174, Opposite State Bank of India Head Office, Bank Street Road, Koti, Hyderabad, 500095 India
| | - Sudarshan Reddy Loka
- Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No 5-1-174, Opposite State Bank of India Head Office, Bank Street Road, Koti, Hyderabad, 500095 India
| | - Anju Susan Jacob
- Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No 5-1-174, Opposite State Bank of India Head Office, Bank Street Road, Koti, Hyderabad, 500095 India
| | - Sai Maley
- NRG Oncology/Hillman Cancer Center, NSABP Foundation, Inc., 1307 Federal St, Suite 303, Pittsburgh, PA 15212 USA
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Ho YT, Lee LY, Fu CH. Patient With Unilateral Nasal Obstruction and a Nasal Mass. JAMA Otolaryngol Head Neck Surg 2024; 150:179-180. [PMID: 38060219 DOI: 10.1001/jamaoto.2023.3817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
A 65-year-old man presented with a 2-year history of left nasal obstruction and large tumor in the left nasal cavity. What is your diagnosis?
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Affiliation(s)
- Yan-Ting Ho
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Li-Yu Lee
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hsiang Fu
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Rajanna LB, Datta R, Raina S, Bayad HC, Madakshira MG, Upadhyay K, Tripathi S, Srivastava A, Chahar OS, Singh O. Our Experience with Sinonasal Glomangiopericytoma in North India: A Case Series. Indian J Otolaryngol Head Neck Surg 2024; 76:88-93. [PMID: 38440622 PMCID: PMC10908769 DOI: 10.1007/s12070-023-04088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/13/2023] [Indexed: 03/06/2024] Open
Abstract
Glomangiopericytoma (GPC) is a rare benign sinonasal tumor originating from Zimmerman's Pericytes surrounding capillaries and accounting for less than 0.05% of all sinonasal tumors. Glomangiopericytoma has low malignant potential (5-10%) and is mostly diagnosed in the 6th or 7th decade of age with slight female preponderance. We presented here a case series of 5 patients with sinonasal GPC. This research was conducted at a tertiary healthcare centre in North India. In our case series, all the patients were evaluated and underwent endoscopic surgical resection. All patients underwent digital subtraction angiography (DSA) and preoperative embolization. The coblation technique used for haemostasis proved very effective and time-saving. All patients exhibited cytoplasmic SMA positivity (a marker of GPC) and CD34 negativity, while one patient exhibited a high Ki-67 index (> 10%), which is a predictor of aggressive tumor behavior. None of the patients showed any recurrence in follow-up. We recommend performing complete endoscopic surgical excision to prevent recurrence. The use of DSA, preoperative embolization, and intraoperative use of the coblation technique provides a cleaner surgical field and reduced operating time.
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Affiliation(s)
- Lohith Banavara Rajanna
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Rakesh Datta
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Sheetal Raina
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Himanshu Chhagan Bayad
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Manoj Gopal Madakshira
- Department of Pathology, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Kiran Upadhyay
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Shailendra Tripathi
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Anchita Srivastava
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Omvir Singh Chahar
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Ombir Singh
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
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Arnous NK, Alkholaiwi F, Alrasheed AS. Sinonasal Glomangiopericytoma with Skull Base Involvement: A Diagnostic Dilemma. EAR, NOSE & THROAT JOURNAL 2024:1455613231223900. [PMID: 38229414 DOI: 10.1177/01455613231223900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
Introduction: Glomangiopericytoma (GPC) is a rare type of neoplasm with hemangiopericytoma-like vasculature and perivascular hyalinization of capillary-sized veins. CD34 and S100 protein staining might be positive in a small percentage of GPC. Solitary fibrous tumors (SFTs) present clinically like GPC. However, challenges remain when differentiating GPC from SFT. Case Presentation: A 37-year-old male, smoker, presented with 3 years history of right-sided epistaxis and nasal congestion. He was also complaining of hyposmia but no headaches or visual complaints. On nasal endoscopy, he was found to have a right-sided nasal mass occupying the ethmoid cavity. Computed tomography showed a right sinonasal mass abutting the anterior skull base and magnetic resonance imaging demonstrated a hyperintense, enhancing mass within the right ethmoid cavity, superior septum, and anterior skull base. The patient underwent endoscopic resection with gross total resection and skull base reconstruction. Postoperative pathology initially was thought to be an SFT; however, subsequent STAT6 expression was negative, and therefore GPC diagnosis was confirmed. At the most recent follow-up (6 months), the patient remained free of local disease. Discussion: SFT, unlike GPC, stains strongly for CD34, in this case, due to strong CD34, the diagnosis of SFT was initially made. Nuclear STAT6 expression is highly specific and sensitive for SFT. This later returned as negative; therefore, GPC was confirmed. Conclusion: We present a case of sinonasal GPC with skull base involvement that was treated with endoscopic resection. At the most recent follow-up (6 months), the patient remained free of local disease.
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Affiliation(s)
| | - Feras Alkholaiwi
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulaziz S Alrasheed
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Kushwaha A, Khaimeichho N, Jinkala S, Penubarthi LK. Unveiling a Rarity: A Case Report on Glomangiopericytoma in the nasal cavity. Indian J Otolaryngol Head Neck Surg 2023; 75:3917-3919. [PMID: 37974783 PMCID: PMC10645710 DOI: 10.1007/s12070-023-03975-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 11/19/2023] Open
Abstract
Sino-nasal glomangiopericytoma is a rare benign tumour comprising only about 0.5% of all sino-nasal tumours. Presenting as a bleeding nasal mass, it is among the myriad of differential diagnoses for the same. Clinical characterisation of mass becomes difficult; hence, histopathology and immunohistocytochemistry play an essential role in clenching the diagnosis. Optimal treatment includes complete tumour excision with endoscopic or open approaches with or without preoperative embolization and a long post-operative follow-up period. Here we report such a case treated with endoscopic approach. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03975-z.
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Affiliation(s)
- Akshat Kushwaha
- Department of otorhinolaryngology JIPMER, Puducherry-06, India
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Iwata S, Kitazawa R, Kitazawa S, Hato N. Glomangiopericytoma with CTNNB1 mutation. BMJ Case Rep 2023; 16:e256787. [PMID: 37723085 PMCID: PMC10510870 DOI: 10.1136/bcr-2023-256787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Glomangiopericytoma (GPC) is a rare tumour, accounting <0.5% of all nasal cavity tumours. It is classified as borderline malignant to indolent and is associated with perivascular myeloid cells. We report a case of GPC in a woman in her 80s who presented with nasal obstruction. The tumour originated from the nasal septum and was resected via endoscopic sinus surgery. Histopathological examination revealed dense spindle-shaped to oval-shaped mesenchymal cells forming tumour nodules with staghorn-like vessel formation. Immunohistochemical analysis revealed that the tumour cells were positive for α-smooth muscle actin, CD34, β-catenin and cyclin D1, whereas they were negative for STAT6. The percentage of Ki-67-positive cells was approximately 2%. Recent studies have demonstrated a high frequency of β-catenin (CTNNB1) mutations in GPC. We report a case of GPC where identifying CTNNB1 mutations (c.94G>C, p.D32H) was crucial for establishing a definitive diagnosis.
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Affiliation(s)
- Shinji Iwata
- Otolaryngology, Ehime Prefectural Niihama Hospital, Niihama, Japan
| | - Riko Kitazawa
- Molecular Pathology, Ehime University Hospital, Toon, Japan
| | - Sohei Kitazawa
- Molecular Pathology, Ehime University Hospital, Toon, Japan
| | - Naohito Hato
- Otolaryngology, Ehime University Hospital, Toon, Japan
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Akay S, Pollard JH, Saad Eddin A, Alatoum A, Kandemirli S, Gholamrezanezhad A, Menda Y, Graham MM, Shariftabrizi A. PET/CT Imaging in Treatment Planning and Surveillance of Sinonasal Neoplasms. Cancers (Basel) 2023; 15:3759. [PMID: 37568575 PMCID: PMC10417627 DOI: 10.3390/cancers15153759] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Sinonasal cancers are uncommon malignancies with a generally unfavorable prognosis, often presenting at an advanced stage. Their high rate of recurrence supports close imaging surveillance and the utilization of functional imaging techniques. Whole-body 18F-FDG PET/CT has very high sensitivity for the diagnosis of sinonasal malignancies and can also be used as a "metabolic biopsy" in the characterization of some of the more common subgroups of these tumors, though due to overlap in uptake, histological confirmation is still needed. For certain tumor types, radiotracers, such as 11C-choline, and radiolabeled somatostatin analogs, including 68Ga-DOTATATE/DOTATOC, have proven useful in treatment planning and surveillance. Although serial scans for posttreatment surveillance allow the detection of subclinical lesions, the optimal schedule and efficacy in terms of survival are yet to be determined. Pitfalls of 18F-FDG, such as post-surgical and post-radiotherapy crusting and inflammation, may cause false-positive hypermetabolism in the absence of relapse.
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Affiliation(s)
- Sinan Akay
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Janet H. Pollard
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Assim Saad Eddin
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Aiah Alatoum
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Sedat Kandemirli
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90030, USA
| | - Yusuf Menda
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Michael M. Graham
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ahmad Shariftabrizi
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
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Warman M, Syn-Hershko A, Cohen O, Tzipin Y, Lahav Y, Tessler I. Sino-nasal hemangiopericytoma: a case series and systematic literature review. Eur Arch Otorhinolaryngol 2022; 279:3989-3996. [PMID: 35103868 DOI: 10.1007/s00405-021-07239-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hemangiopericytoma is a rare tumor of the sino-nasal tract. Its clinical behavior is controversial. Whereas some describe an indolent course, others consider it to be an aggressive lesion with a tendency toward rapid local recurrence. Here, we describe our experience in the management of sino-nasal hemangiopericytoma (SN-HPC), comparing our experience with the current literature, and evaluating signs and tools to improve diagnosis and treatment. METHODS All cases of SN-HPC between 2010 and 2020 were extracted and reviewed from our institutional electronic medical records. SN-HPC cases from PubMed and EMBASE between 2010 and 2020 were analyzed in a systematic literature review using the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. Data regarding demographics, presentation, diagnosis, treatment, and outcome were collected. RESULTS We identified four cases of SN-HPC in the nasal cavity in our institution and an additional 53 cases in previous reports. The mean age at the time of diagnosis was 59 years, with a 1.2:1 male to female ratio. SN-HPC mostly appears unilaterally, arising in the ethmoid sinus (42.1%). The most common presenting symptoms were epistaxis (47.3) and nasal obstruction (47.3%). Both computed tomography (CT) and magnetic resonance imaging (MRI) were required for diagnosis and for tailoring the treatment plan. Endoscopic surgical excision was used in 85.9% of the patients, and in 15.7%, an additional preoperative embolization was performed, which was associated with septal necrosis in one patient (2.6%). The recurrence rate was 7%. CONCLUSION Although previous reports attribute an aggressive tumoral behavior to SN-HPC, our experience and the literature review support a more indolent course with low recurrence rates following complete endoscopic resection. Preoperative embolization can be useful in certain cases, but due to potential complications, it should not be routinely indicated.
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Affiliation(s)
- Meir Warman
- Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, POB 1, 76100, Rehovot, Israel. .,Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Adi Syn-Hershko
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oded Cohen
- Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, POB 1, 76100, Rehovot, Israel.,Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yevgeny Tzipin
- Department of Radiology, Invasive Radiology Unit, Kaplan Medical Center, Rehovot, Israel
| | - Yonatan Lahav
- Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, POB 1, 76100, Rehovot, Israel.,Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Idit Tessler
- Department of Otolaryngology, Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel
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Al-Jobory YM, Pan Z, Manes RP, Omay SB, Ikuta I. Sinonasal Glomangiopericytoma: Review of Imaging Appearance and Clinical Management Update for a Rare Sinonasal Neoplasm. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2021; 94:593-597. [PMID: 34970096 PMCID: PMC8686777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction: Glomangiopericytoma (GPC) is a rare tumor in the nasal cavity or paranasal sinuses with low malignant potential. Initially deemed a hemangiopericytoma, in 2005 it was classified as a distinct entity by the World Health Organization (WHO). Case Presentation: A male patient in his early 60s presented with new-onset right arm and leg weakness/numbness, who was incidentally found to have a left ethmoid sinus mass with extension in the olfactory fossa. On CT and MRI, the mass enhanced with well-defined borders and eroded the bone, but without dural enhancement. The mass was surgically excised, and pathology confirmed the diagnosis of glomangiopericytoma by microscopic appearance and staining. Discussion: Glomangiopericytoma has less than 0.5% incidence of all neoplasms of the sinonasal cavity, making it rare. Most diagnosed patients are in their 6th or 7th decade of age, with a slight female predominance. Treatment is complete surgical excision, with excellent prognosis, although there is up to 17% local recurrence. Despite the non-specific appearance on CT and MRI, imaging can help provide differential diagnosis, tumor extent, size, and reassuring non-aggressive characteristics of the tumor prior to surgery. GPC tumors are relatively resistant to radiation and chemotherapy. Conclusion: It is important to recognize glomangiopericytoma in the differential of masses of the nasal cavities or paranasal sinuses, as they rarely warrant aggressive treatment beyond local excision. Each reported case of glomangiopericytoma helps to build guidance for imaging and treatment since GPC is rare and not well-represented in the medical literature.
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Affiliation(s)
- Yaser M. Al-Jobory
- Radiology & Biomedical Imaging, Yale University
School of Medicine, New Haven, CT, USA
| | - Zenggang Pan
- Department of Pathology, Yale University School of
Medicine, New Haven, CT, USA
| | - R. Peter Manes
- Department of Surgery, Division of Otolaryngology, Yale
University School of Medicine, New Haven, CT, USA
| | - Sacit B. Omay
- Neurosurgery, Yale University School of Medicine, New
Haven, CT, USA
| | - Ichiro Ikuta
- Radiology & Biomedical Imaging, Yale University
School of Medicine, New Haven, CT, USA,To whom all correspondence should be addressed:
Ichiro Ikuta, Radiology & Biomedical Imaging, Yale University School of
Medicine, New Haven, CT; ; ORCID iD:
https://orcid.org/0000-0002-7145-833X
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Kazi AA, McDougal EM, Howell JB, Schuman TA, Nord RS. Glomangiopericytoma: a case series with review of literature. Braz J Otorhinolaryngol 2021; 88:817-820. [PMID: 33744192 PMCID: PMC9483992 DOI: 10.1016/j.bjorl.2021.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/19/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Aasif A Kazi
- Virginia Commonwealth University, Department of Otolaryngology - Head and Neck Surgery, Richmond, VA, United States
| | | | - Jessica B Howell
- Otolaryngology Associates of Tennessee, Nashville, TN, United States
| | - Theodore A Schuman
- Virginia Commonwealth University, Department of Otolaryngology - Head and Neck Surgery, Richmond, VA, United States
| | - Ryan S Nord
- Virginia Commonwealth University, Department of Otolaryngology - Head and Neck Surgery, Richmond, VA, United States.
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Chaouki A, Najib Z, Mkhatri A, Rouadi S, Mahtar M. Glomangiopericytoma of the inferior nasal turbinate: A case report. Int J Surg Case Rep 2021; 79:409-412. [PMID: 33517215 PMCID: PMC7848696 DOI: 10.1016/j.ijscr.2021.01.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/25/2022] Open
Abstract
Glomangiopericytomas, which arises in the nasal cavity and may extend into the paranasal sinuses, is categorized as a borderline low malignancy tumor by the WHO classification. Complete transnasal endoscopic excision is the optimal treatment. A regular postoperative follow-up is recommended for early finding of tumor recurrence.
Introduction Glomangiopericytoma is defined as a sinonasal tumor with perivascular myoid phenotype, which was first described in 1942 by Stout and Murray as a soft tissue tumor with characteristic proliferation including branching vessels and small vessel perivascular hyalinization. The tumor accounts for less than 0.5 % of all sinonasal neoplasms. The World Health Organization (WHO) classified this tumor as glomangiopericytoma in 2005. Case report A 47-year-women presented with two years history of permanent left nasal obstruction and frequent epistaxis. Rhinoscopy revealed a friable grayish pink polypoidal mass, fully occupying the left anterior naris. Computed tomography showed a lesion involving the left nasal cavity, with a soft tissue density (70 UH) measuring 50 × 16 mm, widely infiltrative. Endoscopic surgery was performed to remove the mass, considering the size, limited expansion and the accessible location of the tumor. The immunohistochemistry examination showed positive staining b-catenin tumor cells which confirmed the diagnostic of glomangiopericytoma. After a 2 years follow-up, the patient showed no signs of recurrence. Conclusion Glomangiopericytomas generally arises in the nasal cavity and may extend into the paranasal sinuses. It is categorized as a borderline low malignancy tumor by the WHO classification. Complete transnasal endoscopic excision is the optimal treatment.
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Affiliation(s)
- A Chaouki
- Faculty of Medecine of Casablanca, Morocco.
| | - Z Najib
- Faculty of Medecine of Casablanca, Morocco
| | - A Mkhatri
- Faculty of Medecine of Casablanca, Morocco
| | - S Rouadi
- Faculty of Medecine of Casablanca, Morocco
| | - M Mahtar
- Faculty of Medecine of Casablanca, Morocco
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Gökyer A, Sayın S, Küçükarda A, Çelik M, Güldiken S, Çiçin İ. Nasal hemangiopericytoma presenting with oncogenic osteomalasia: A case report and literature review. Curr Probl Cancer 2021; 45:100704. [PMID: 33446319 DOI: 10.1016/j.currproblcancer.2020.100704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/05/2020] [Accepted: 12/04/2020] [Indexed: 12/01/2022]
Abstract
Sinonasal type hemangiopericytoma is a rare soft tissue tumor. Oncogenic osteomalacia (tumor-induced osteomalacia) is a rare syndrome that develops especially due to benign mesenchymal tumors. Nonspecific general bone pain and weakness delay the diagnosis and treatment of oncogenic osteomalacia, and it is difficult to determine the localization of the primary tumor causing oncogenic osteomalacia. A 43-year-old male patient with nasal hemangiopericytoma with symptoms of oncogenic osteomalacia is presented. The patient had musculoskeletal complaints at first and was diagnosed with lumbar disc herniation and surgery was performed. When his complaints recurred 1 year later, he was re-evaluated and diagnosed with hypophosphatemic osteomalacia. Despite the various treatments he received, his complaints did not decrease but increased, so a detailed examination was decided. When the positive PHEX mutation and very high fibroblast growth factor 23 level were detected, PET-CT imaging was performed with a pre-diagnosis of possible oncogenic osteomalacia, but no finding was found. Then he was evaluated with Ga-68 DOTATATE, and the soft tissue mass filling the right ethmoidal sinus was detected. Due to the relation of the mass with surrounding structures, it was considered unsuitable for total excision and incomplete surgical excision was performed. Pathologic evaluation revealed sinonasal type hemangiopericytoma (glomangiopericytoma). A significant remission in the patient's complaints was observed after the operation. Young patients with osteomalacia with unknown causes should be evaluated for malignancy, and screening and further examinations should be performed.
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Affiliation(s)
- Ali Gökyer
- Trakya University School of Medicine, Department of Internal Medicine, Division of Medical Oncology, Edirne, Turkey.
| | - Sezin Sayın
- Trakya University School of Medicine, Edirne, Turkey
| | - Ahmet Küçükarda
- Trakya University School of Medicine, Department of Internal Medicine, Division of Medical Oncology, Edirne, Turkey
| | - Mehmet Çelik
- Trakya University School of Medicine, Department of Internal Medicine, Division of Endocrinology, Edirne, Turkey
| | - Sibel Güldiken
- Trakya University School of Medicine, Department of Internal Medicine, Division of Endocrinology, Edirne, Turkey
| | - İrfan Çiçin
- Trakya University School of Medicine, Department of Internal Medicine, Division of Medical Oncology, Edirne, Turkey
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Obeidin F, Jennings LJ, Alexiev BA. Sinonasal glomangiopericytoma: A clinicopathologic study. Pathol Res Pract 2019; 215:983-987. [PMID: 30739805 DOI: 10.1016/j.prp.2019.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
Sinonasal glomangiopericytoma (SNGP) is a neoplasm arising in the nasal cavity and paranasal sinuses that shows perivascular myoid differentiation. The diagnosis of SNGP may be diagnostically challenging due to a large number of potential mimics. In the present study, we sought to characterize the histological and molecular features of six cases of SNGP found in prior surgical pathology records over a 15-year period. The average age at diagnosis was 48.5 years (range: 31-78 years), and the male-to-female ratio was 1:1. Imaging studies in all six cases demonstrated avidly enhancing, lobulated soft tissue masses in the nasal cavity, extending into the sinuses and nasopharynx. Histologically, the tumors were unencapsulated and composed of a proliferation of closely packed, bland, and uniform spindle cells growing deep to an intact surface respiratory epithelium. The cells were separated by a distinctive vascular network ranging from capillaries to large vascular spaces. All cases demonstrated strong positivity for smooth muscle actin, cyclin D1, CD99, and β-catenin (100%). Targeted sequencing revealed recurrent CTNNB1 missense mutations in all cases tested. Additionally, TLE1 was positive in all cases which has not been previously reported. No tested cases harbored SS18 translocations. We found that while no single marker resolves immunohistochemical overlap between SNGP and its histologic mimics, an extended immunohistochemical panel that includes β-catenin, cyclin D1, STAT6, smooth muscle actin, pan-cytokeratin cocktails, S100, and SOX10 helps to support the diagnosis of SNGP in diagnostically challenging cases without the need for molecular studies.
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Affiliation(s)
- Farres Obeidin
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 251 East Huron St, Feinberg 7-342A, Chicago, IL, 60611, United States
| | - Lawrence J Jennings
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 251 East Huron St, Feinberg 7-342A, Chicago, IL, 60611, United States
| | - Borislav A Alexiev
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 251 East Huron St, Feinberg 7-342A, Chicago, IL, 60611, United States.
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Muranjan S, Bommakanti VJ, Shah N. Coblator assisted resection of sinonasal Hemangiopericytoma-A case report. OTOLARYNGOLOGY CASE REPORTS 2018. [DOI: 10.1016/j.xocr.2018.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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15
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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 2018; 13:298-303. [PMID: 30206803 PMCID: PMC6684555 DOI: 10.1007/s12105-018-0961-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/18/2018] [Indexed: 12/25/2022]
Abstract
Glomangiopericytoma (GPC) is a rare mesenchymal tumor arising from the nasal cavity or paranasal sinuses. GPC was categorized as a borderline and low-malignant-potential tumor by the World Health Organization in 2005 and accounts for less than 0.5% of all sinonasal tumors. We report a case of GPC in a 74-year-old woman with a history of recurrent epistaxis and nasal obstruction. A reddish tumor was seen in the right nasal cavity. Enhanced computed tomography showed a mass lesion occupying the right nasal cavity. The tumor, which originated from the nasal septum in the olfactory fissure area, was resected with 5-mm mucosal margins by endoscopic sinus surgery. Histologic examination revealed a uniform proliferation of oval-to-short spindle-shaped cells beneath the epithelium. Immunohistologic analysis demonstrated the tumor cells were positive for α-smooth muscle actin, β-catenin and Vimentin, and negative for AE1/AE3, Bcl-2, CD34, CD117, Factor VIIIR Ag, S-100 protein, or STAT6. The percentage of Ki-67-positive cells was approximately 5%. Genetic analysis using next-generation sequencing revealed a missense mutation in the CTNNB1 gene (c.110C > G, p.S37C). While other CTNNB1 mutations have been described in GPC; this is the first report of this specific mutation. The mutation was confirmed using Sanger sequencing.
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Affiliation(s)
- Michihisa Kono
- 0000 0004 0595 9093grid.452447.4Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Inadacho Kisen 7-5, Obihiro, 080-0833 Japan ,0000 0000 8638 2724grid.252427.4Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, 078-8510 Japan
| | - Nobuyuki Bandoh
- 0000 0004 0595 9093grid.452447.4Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Inadacho Kisen 7-5, Obihiro, 080-0833 Japan
| | - Ryosuke Matsuoka
- 0000 0004 0531 3030grid.411731.1Center for Diagnostic Pathology, Mita Hospital, International University of Health and Welfare, Tokyo, 108-8329 Japan
| | - Takashi Goto
- 0000 0004 0595 9093grid.452447.4Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Inadacho Kisen 7-5, Obihiro, 080-0833 Japan
| | - Toshiaki Akahane
- 0000 0004 0595 9093grid.452447.4Laboratory of Cancer Medical Science, Department of Biology and Genetics, Hokuto Hospital, Inadacho Kisen 7-5, Obihiro, 080-0833 Japan
| | - Yasutaka Kato
- 0000 0004 0595 9093grid.452447.4Laboratory of Cancer Medical Science, Department of Biology and Genetics, Hokuto Hospital, Inadacho Kisen 7-5, Obihiro, 080-0833 Japan
| | - Hiroshi Nakano
- 0000 0004 0595 9093grid.452447.4Laboratory of Cancer Medical Science, Department of Biology and Genetics, Hokuto Hospital, Inadacho Kisen 7-5, Obihiro, 080-0833 Japan
| | - Tomomi Yamaguchi
- 0000 0004 0595 9093grid.452447.4Laboratory of Cancer Medical Science, Department of Biology and Genetics, Hokuto Hospital, Inadacho Kisen 7-5, Obihiro, 080-0833 Japan
| | - Yasuaki Harabuchi
- 0000 0000 8638 2724grid.252427.4Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, 078-8510 Japan
| | - Hiroshi Nishihara
- 0000 0004 1936 9959grid.26091.3cKeio Cancer Center, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo, 160-8582 Japan
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Smith SC, Gooding WE, Elkins M, Patel RM, Harms PW, McDaniel AS, Palanisamy N, Uram-Tuculescu C, Balzer BB, Lucas DR, Seethala RR, McHugh JB. Solitary Fibrous Tumors of the Head and Neck: A Multi-Institutional Clinicopathologic Study. Am J Surg Pathol 2017; 41:1642-1656. [PMID: 28877055 PMCID: PMC5680135 DOI: 10.1097/pas.0000000000000940] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Solitary fibrous tumors (SFTs) of the head and neck are uncommon. Lesions previously diagnosed in the head and neck as hemangiopericytomas (HPCs), giant cell angiofibromas (GCAs), and orbital fibrous histiocytomas (OFHs) are now recognized as within the expanded spectrum of SFTs. To better understand the clinicopathologic profile of head and neck SFTs, we performed a multi-institutional study of 88 examples. There was no sex predilection (F:M ratio 1.2), and the median patient age was 52 years (range: 15 to above 89 y). The sinonasal tract and orbit were the most common sites involved (30% and 25%), followed by the oral cavity and salivary glands (15% and 14%). Original diagnoses included HPC (25%), SFT (67%), and OFH (6%), with 1 SFT and 1 OFH noted as showing GCA-like morphology. On review, the predominant histologic pattern was classic SFT-like in 53% and cellular (former HPC-like) in 47%; lipomatous differentiation (8%) and GCA-like pattern (7%) were less prevalent. Subsets demonstrated nuclear atypia (23%), epithelioid morphology (15%), or coagulative necrosis (6%). Infiltrative growth (49%) and osseous invasion (82%) were prevalent among evaluable cases. Of the 48 SFTs with follow-up (median: 43 mo), 19 showed recurrence (40%). Of these, 4 patients were alive with disease and 4 dead of disease. Size and mitotic rate were negative prognosticators using a joint prognostic proportional hazards regression model. Three patients experienced metastasis, to lungs, parotid, bone, and skull base, including one case showing overtly sarcomatous "dedifferentiation." As a group, SFTs present in a wide anatomic and morphologic spectrum in the head and neck. Only rare examples metastasize or cause death from disease. However, the fairly high local recurrence rate underscores their aggressive potential and highlights the importance of prospective recognition.
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Affiliation(s)
- Steven C Smith
- *Departments of Pathology and Surgery, VCU School of Medicine, Richmond, VA †Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA §Biostatistics Facility, University of Pittsburgh Cancer Institute **Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA ∥Department of Pathology, SUNY Upstate Medical University, Syracuse, NY Departments of ‡Pathology ¶Dermatology ††Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor #Department of Urology, Henry Ford Health System, Detroit, MI
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Park ES, Kim J, Jun SY. Characteristics and prognosis of glomangiopericytomas: A systematic review. Head Neck 2017; 39:1897-1909. [DOI: 10.1002/hed.24818] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/07/2016] [Accepted: 04/07/2017] [Indexed: 12/12/2022] Open
Affiliation(s)
- Eun Su Park
- Department of Pathology; Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Incheon Republic of Korea
| | - Jiyoung Kim
- Department of Pathology; Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Incheon Republic of Korea
| | - Sun-Young Jun
- Department of Pathology; Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Incheon Republic of Korea
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Asimakopoulos P, Syed MI, Andrews T, Syed S, Williams A. Sinonasal glomangiopericytoma: Is anything new? EAR, NOSE & THROAT JOURNAL 2017; 95:E1-5. [PMID: 26930335 DOI: 10.1177/014556131609500202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
More than 100 cases of sinonasal hemangiopericytoma have been reported in the literature, but only a handful of cases of nasal glomangiopericytoma. In this article, we report a case of a nasal glomangiopericytoma that was treated with endonasal surgical excision. We also attempt to clarify the confusion that attends to the nomenclature surrounding the terms glomangiopericytoma and hemangiopericytoma, which are often used interchangeably. Although glomangiopericytomas are histologically similar to sinonasal hemangiopericytomas, they sometimes behave in a different clinical manner. To further enhance our understanding of nasal glomangiopericytomas, more cases need to be reported. This may improve our ability to establish specific treatment modalities for this type of neoplasm and to predict clinical outcomes.
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Affiliation(s)
- Panagiotis Asimakopoulos
- Corresponding author: Mr. Mohammed Iqbal Syed, Department of Otolaryngology, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Rd., Edinburgh EH16 4SA, UK. From the Department of Otolaryngology (Mr. Asimakopoulos, Mr. M.I. Syed, and Dr. Williams) and the Department of Pathology (Dr. Andrews and Dr. S. Syed), The Royal Infirmary of Edinburgh, Edinburgh, Scotland
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19
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Simmonds JC, Rebeiz EE. Surgical resection of sinonasal hemangiopericytoma involving anterior skull base: Case reports and literature review. Am J Otolaryngol 2017; 38:87-91. [PMID: 27773560 DOI: 10.1016/j.amjoto.2016.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 09/25/2016] [Indexed: 11/24/2022]
Abstract
Hemangiopericytomas are soft tissue tumors composed of pericytic cells that are characterized by their "staghorn" vascular branching and their variable clinical presentation. Fifteen to 25% of all HPC occur in the head and neck, with only 5% found in the nose or paranasal sinuses. Sinonasal hemangiopericytoma (SNHPC) is considered distinct from its soft tissue counterpart - the former showing a more uniform cellular organization, has convincing pericytic differentiation and is associated with a far better prognosis. With less than 200 cases of SNHPC reported in the literature, only limited assumptions can be made about this rare tumor. The purpose of this article is to add to the growing body of literature on this disease. We report two new cases of SNHCP - both in female patients who presented with epistaxis and anosmia. Pulsatile vascular masses were visualized with nasal endoscopy - one in the left middle meatus and the second one near the cribriform plate. CT and MRI studies show enhancing masses in the left nasal cavities with thinning and erosion of the skull base. Diagnoses were confirmed by pathology which reported spindle cell neoplasm staining positively for VEGF, NSE, factor XIIIa, S-100 protein, and CD34, and negative for actin, desmin, CD31, and pankeratin, consistent with hemangiopericytoma. In one patient, embolization of the sphenopalatine and labial artery as well as pre-operative radiation therapy was performed before complete endoscopic resection was undertaken. The second patient had a tumor invading the skull base, so a craniofacial resection was performed. Both patients remained free of disease two years after surgery. Review of the literature and treatment options are discussed.
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20
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Shetty KJ, Rao C, Prasad HLK. Glomangiopericytoma Versus Solitary Fibrous Tumor: an Omental Tumor with Unusual Diagnostic Dilemma. Indian J Surg Oncol 2016; 7:475-478. [PMID: 27872540 DOI: 10.1007/s13193-016-0522-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 04/19/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- K Jayaprakash Shetty
- Department of Pathology, K. S. Hegde Medical Academy, Deralakatte, Mangalore, 575018 India
| | - Chandrika Rao
- Department of Pathology, K. S. Hegde Medical Academy, Deralakatte, Mangalore, 575018 India
| | - H L Kishan Prasad
- Department of Pathology, K. S. Hegde Medical Academy, Deralakatte, Mangalore, 575018 India
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21
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Psoma E, Karkos PD, Dova S, Gavriilidis M, Markou K, Kouskouras C, Haritanti A, Finitsis S. Sinonasal glomangiopericytoma treated with preoperative embolisation and endoscopic sinus surgery. Ecancermedicalscience 2016; 10:692. [PMID: 27994648 PMCID: PMC5130329 DOI: 10.3332/ecancer.2016.692] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Indexed: 12/23/2022] Open
Abstract
Sinonasal glomangiopericytoma is a benign rare tumour of pericytes that accounts for less than 0.5% of all sinonasal tumours. It is an indolent tumour with a macroscopic appearance of common inflammatory polyps. We report the case of a 55-year-old male who presented with right nasal obstruction. CT and MRI examinations demonstrated a soft-tissue mass that obstructed mainly the right nasal cavity. Biopsy revealed glomangiopericytoma. The tumour was treated with preoperative embolisation followed by complete endoscopic resection. Very few cases have been reported to be treated in this way.
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Affiliation(s)
- Elizabeth Psoma
- Department of Radiology and Interventional Radiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki 54621, Greece
| | - Petros D Karkos
- Department of Otolaryngology-Head and Neck Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki 54621, Greece
| | - Stamatia Dova
- Department of Otolaryngology-Head and Neck Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki 54621, Greece
| | - Michail Gavriilidis
- Department of Radiology and Interventional Radiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki 54621, Greece
| | - Konstantinos Markou
- Department of Otolaryngology-Head and Neck Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki 54621, Greece
| | - Constantinos Kouskouras
- Department of Radiology and Interventional Radiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki 54621, Greece
| | - Afroditi Haritanti
- Department of Radiology and Interventional Radiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki 54621, Greece
| | - Stefanos Finitsis
- Department of Radiology and Interventional Radiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki 54621, Greece
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Abou Al-Shaar H, Macdonald KI, Labib MA. Glomangiopericytoma simulating an intracavernous meningioma. Surg Neurol Int 2016; 7:S142-7. [PMID: 27069746 PMCID: PMC4802986 DOI: 10.4103/2152-7806.177888] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 12/17/2015] [Indexed: 12/20/2022] Open
Abstract
Background: Glomangiopericytoma is an uncommonly encountered tumor of the nose and paranasal sinuses, accounting for <0.5% of all sinonasal tumors. Extension of these lesions to the anterior or middle cranial fossa is rare. When this occurs, diagnosing glomangiopericytoma is extremely challenging, as it is often confused with other anterior skull base tumors. Case Description: We report a case of a giant glomangiopericytoma localizing into the cavernous sinus in a 48-year-old female who presented with mild left-sided ptosis for 48 months. The lesion simulated an intracavernous meningioma on preoperative imaging. An expanded endoscopic endonasal approach was used to debulk the portion of the lesion in the medial compartment of the cavernous sinus. Postoperatively, the patient's ptosis resolved completely, and no new deficits were sustained. Conclusion: This is the only case of glomangiopericytoma localizing solely to the cavernous sinus reported to date.
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Affiliation(s)
| | - Kristian I Macdonald
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Mohamed A Labib
- Department of Neurosurgery, Barrow Neurological Institute and St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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Extensively Myxoid and Hyalinized Sinonasal Capillary Hemangiomas: A Clinicopathologic Study of 16 Cases of a Distinctive and Potentially Confusing Hemangioma Variant. Am J Surg Pathol 2016; 39:1584-90. [PMID: 26291508 DOI: 10.1097/pas.0000000000000485] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Capillary hemangiomas, the most common vascular tumors of the sinonasal region, are benign endothelial neoplasms, typically growing in an easily recognized lobular pattern. Some sinonasal capillary hemangiomas may show atypical features, such as high cellularity or mitotic activity, and represent more challenging diagnoses. Over the past several years we have seen in consultation a number of examples of sinonasal capillary hemangiomas displaying very striking stromal myxoid change and hyalinization, features that have received scant attention in the past. Available slides from 16 sinonasal capillary hemangiomas previously coded as showing such changes were retrieved from our archives. Submitting diagnoses included "query angiofibroma, rule out malignancy" (N=4), "vascular polyp, rule out malignancy" (N=3), "query malignant vascular tumor" (N=4), "sinonasal hemangiopericytoma" (N=1), and "benign vascular tumor" (N=1). Available radiographic studies often showed worrisome features. Grossly, the tumors ranged from 1.1 to 6.0 cm and appeared as ulcerated, vascular-appearing polyps. Microscopically, the tumors showed striking stromal myxoid change and/or hyalinization, which largely obscured the underlying lobular capillary arrangement. Within this myxohyaline matrix, a florid capillary proliferation was present, frequently with nonatypical mitotic activity. In some instances a branching, "hemangiopericytoma-like" vascular pattern was present in areas. The overall cellularity was low to moderate, and endothelial atypia or hyperchromatism was absent. Ulceration and thrombosis were frequently present. Immunostains to CD31, CD34, and SMA highlighted areas of lobular growth pattern inapparent on the routinely stained slides. Four tested cases were negative for androgen receptors and β-catenin. Follow-up from 12 patients revealed no local recurrences or metastases. Awareness of that sinonasal capillary hemangioma may show these unusual stromal changes, and the use of ancillary immunohistochemistry to highlight its lobular growth pattern should allow its confident distinction from more aggressive endothelial tumors (eg, angiosarcoma) and from nonendothelial tumors, including nasopharyngeal angiofibroma, solitary fibrous tumor, and sinonasal hemangiopericytoma-like tumor.
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Immunophenotype Heterogeneity in Nasal Glomangiopericytoma. Case Rep Otolaryngol 2015; 2015:308743. [PMID: 26351605 PMCID: PMC4553305 DOI: 10.1155/2015/308743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/06/2015] [Indexed: 11/26/2022] Open
Abstract
Nasal glomangiopericytoma is rare. The immunophenotype is heterogeneous, more frequently smooth-muscle-actin and CD34-positive. We report expression patterns for several vascular-related proteins such as CD99, CD146, Bcl2, and WT1 as well as for treatment-related proteins such as mTOR and EGFR in a nasal glomangiopericytoma. The patient (woman, 86 years) presented with a left nasal tumefaction. The resected specimen (1.5-cm) showed a glomangiopericytoma. Tumor cells expressed smooth-muscle-actin, CD31, CD34, and progesterone receptor. They also expressed the vascular-cell-related proteins Bcl2, CD99, CD146, and WT1, as well as mTOR and EGFR. Nasal glomangiopericytomas show immunohistochemical heterogeneity for vascular-related markers, suggesting a possible extensive pericytic differentiation. The expression of potential targets for drug treatments such as mTOR and EGFR may impact on the clinical follow-up of these tumors occurring at advanced ages, which may require complex surgery.
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25
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Sinonasal glomangiopericytoma causing oncogenic osteomalacia. Clin Exp Otorhinolaryngol 2014; 7:145-8. [PMID: 24917914 PMCID: PMC4050089 DOI: 10.3342/ceo.2014.7.2.145] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 08/16/2012] [Accepted: 08/17/2012] [Indexed: 11/23/2022] Open
Abstract
A 60-year-old woman suffered from recurrent femur neck fracture. Laboratory data showed serum hypophosphatemia, elevated alkaline phosphatase, normal serum calcium levels, and normal parathyroid hormone levels. Radiological examinations revealed a tumor in the right maxillary alveolar bone. The nasal cavity mass was removed, and the histological features were those of glomangiopericytoma. After removal of the tumor, some of the laboratory data normalized. Based on the clinical features, histopathological diagnosis and postoperative course of events, a diagnosis of glomangiopericytoma causing oncogenic osteomalacia was confirmed. We report a case of oncogenic osteomalacia caused by sinonasal glomangiopericytoma.
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26
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Roubal M, Horra A, Bajja MY, El Ettar H, Abada R, Rouadi S, Mahtar M, Janah A, Kadiri F. [Sinonasal Hemangiopericytoma: diagnostic and therapeutic challenge]. Pan Afr Med J 2014; 18:53. [PMID: 26113887 PMCID: PMC4473787 DOI: 10.11604/pamj.2014.18.53.3456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 05/07/2014] [Indexed: 11/17/2022] Open
Abstract
L'hemangiopericytome est une tumeur vasculaire rare, développée à partir des pericytes des capillaires, dans sa localisation nasosinusienne elle ne représente que 0 .5% de l'ensemble des tumeurs de cette région. Une jeune de 35ans a présenté une tumeur rapidement évolutive au cours du bilan diagnostic, l’étude anatomopathologique a conclu à un hémangiopericytome.
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Affiliation(s)
- Mohamed Roubal
- Service d'ORL et de Chirurgie cervico-faciale, Hôpital 20 Août, CHU Ibn Rochd - Casablanca, Maroc
| | - Aziza Horra
- Service d'ORL et de Chirurgie cervico-faciale, Hôpital 20 Août, CHU Ibn Rochd - Casablanca, Maroc
| | - Mohamed Yahya Bajja
- Service d'ORL et de Chirurgie cervico-faciale, Hôpital 20 Août, CHU Ibn Rochd - Casablanca, Maroc
| | - Hicham El Ettar
- Laboratoire d'étude anatomopathologique moulay Driss Premier- Casablanca, Maroc
| | - Reda Abada
- Service d'ORL et de Chirurgie cervico-faciale, Hôpital 20 Août, CHU Ibn Rochd - Casablanca, Maroc
| | - Sami Rouadi
- Service d'ORL et de Chirurgie cervico-faciale, Hôpital 20 Août, CHU Ibn Rochd - Casablanca, Maroc
| | - Mohamed Mahtar
- Service d'ORL et de Chirurgie cervico-faciale, Hôpital 20 Août, CHU Ibn Rochd - Casablanca, Maroc
| | - Abdelaziz Janah
- Service d'ORL et de Chirurgie cervico-faciale, Hôpital 20 Août, CHU Ibn Rochd - Casablanca, Maroc
| | - Fatmi Kadiri
- Service d'ORL et de Chirurgie cervico-faciale, Hôpital 20 Août, CHU Ibn Rochd - Casablanca, Maroc
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27
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Kamath PM, Vijendra Shenoy S, Nirupama M, Vinay Raj T. Hemangiopericytoma: A rare sinonasal tumor. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.ejenta.2013.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Morrison EJ, Wei BPC, Fancourt T, Lyons B. Glomangiopericytoma: overview and role for open surgery. ANZ J Surg 2013; 82:648-50. [PMID: 22943077 DOI: 10.1111/j.1445-2197.2012.06120.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
Glomangiopericytoma (sinonasal-type hemangiopericytoma) is a rare tumor arising from the periyctes surrounding capillaries and accounts for less than 0.5% of all sinonasal tumors. It falls within the category of borderline and low-malignant-potential soft tissue tumors of the nose and paranasal sinuses. It is defined by the World Health Organization as a sinonasal tumor demonstrating a perivascular myoid phenotype. It was noted that when this lesion arose in the nasal cavity, it tended to behave in a more indolent fashion than its soft tissue counterpart, suggesting that sinonasal hemangiopericytomas represented a distinct entity. We report a case of a 68-year-old female patient diagnosed with glomangiopericytoma arising in the left sinonasal cavity and discussed the condition in terms of differential diagnosis.
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Glomangiopericytoma (sinonasal-type haemangiopericytoma). The Journal of Laryngology & Otology 2012; 126:1069-72. [DOI: 10.1017/s0022215112001569] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Glomangiopericytoma is a rare sinonasal tumour of perivascular myoid phenotype, which accounts for less than 1 per cent of all sinonasal tumours.Objective:Discussion of the clinical presentation, histopathological features and advances in the management of sinonasal and skull base glomangiopericytoma.Case report:A 32-year-old woman presented with worsening nasal obstruction, anosmia, severe frontal headaches and right-sided proptosis. Radiographic and endoscopic examination revealed a right-sided, vascular mass involving the nasal cavity, paranasal sinuses and anterior skull base. Histopathological features were consistent with a glomangiopericytoma. Complete endoscopic resection with free margins was achieved.Conclusion:Glomangiopericytomas are rare, vascular, sinonasal tumours. Successful management depends on complete resection, traditionally achieved via an open approach. However, recent advances in endoscopic surgical approaches have enabled complete endoscopic resection of these tumours, minimising morbidity and facilitating subsequent surveillance of the operative site.
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Sinonasal tumors: a clinicopathologic update of selected tumors. Eur Arch Otorhinolaryngol 2012; 270:5-20. [PMID: 22610012 DOI: 10.1007/s00405-012-2025-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 04/17/2012] [Indexed: 12/11/2022]
Abstract
The sinonasal cavities show a wide variety of neoplasms of epithelial, mesenchymal, neural/neuroectodermal or hematopoietic origin. The differential diagnosis for these tumors may be difficult due to overlapping morphologies, variable patterns in ancillary studies, and potentially confusing terminology. In this report, an updated review of the spectrum of neoplasia is provided, using the World Health Organization 2005 classification as a guide. Classic tumors that are generally limited to the sinonasal tract are described and new information regarding molecular pathogenesis is reviewed. Also new entities that have the sinonasal tract as a site of predilection, such as sinonasal renal cell-like adenocarcinoma and NUT midline carcinoma are highlighted.
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Brandwein-Gensler M, Siegal GP. Striking pathology gold: a singular experience with daily reverberations: sinonasal hemangiopericytoma (glomangiopericytoma) and oncogenic osteomalacia. Head Neck Pathol 2012; 6:64-74. [PMID: 22430770 PMCID: PMC3311951 DOI: 10.1007/s12105-012-0337-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 01/25/2012] [Indexed: 01/10/2023]
Abstract
Sinonasal hemangiopericytoma-like tumors(SNHPC)(glomangiopericytomas)were originally conceived as histologically similar to, but biologically distinct from, their soft tissue counterparts. Re-evaluation of "hemangiopericytiomas" has determined that SNHPC (glomangiopericytomas) represent bona-fide pericyte-derived tumors, whereas most soft tissue neoplasms previously designated as hemangiopericytomas represent cellular variants of solitary fibrous tumors or other lesions with a hemangiopericytomalike growth pattern. We present an interesting case of a woman with SNHPC (glomangiopericytomas) causing oncogenic osteomalacia, and discuss the recent advances in our understanding of phosphaturic mesenchymal tumors. This particular case is an example of "Striking Pathology Gold"-a situation where the pathologist actively guides the diagnostic process, and witnesses its repercussions. "Striking Pathology Gold" may be a rare event in one's career. However it serves to remind us of our place in the world as physicians. Working behind the scenes, we quietly change the course of countless individual destinies for the better.
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Affiliation(s)
| | - Gene P. Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Al UK
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Chihani M, Aljalil A, Touati M, Zoubeir Y, Labraimi A, Ammar H, Bouaity B. Glomangiopericytoma: An uncommon sinonasal perivascular tumor with particular characteristics. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.ejenta.2012.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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LeBlanc RE, Taube J. Myofibroma, Myopericytoma, Myoepithelioma, and Myofibroblastoma of Skin and Soft Tissue. Surg Pathol Clin 2011; 4:745-759. [PMID: 26837646 DOI: 10.1016/j.path.2011.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The authors address a group of loosely associated, characteristically benign soft tissue neoplasms that exhibit partial myoid differentiation. The entities share similarities in morphology and in nomenclature that have historically created confusion. The authors attempt to clarify the distinct architectural patterns and the corresponding immunophenotypic and ultrastructural features that distinguish myofibroma, myopericytoma, myoepithelioma, and myofibroblastoma.
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Affiliation(s)
- Robert E LeBlanc
- Department of Pathology, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Janis Taube
- Departments of Dermatology and Pathology, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA
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