PMC10124557_01
Non-enhanced CT scan showed in: A - an expansile soft tissue mass occupying the left nasal cavity, with hyperdensity and extending to the nasopharynx with a significant invasion to the left maxillary sinus; B - the mass showed close contact with the medial rectal muscle of the left eye.
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Remarkably, slight contact between the mass and the left eye medial rectus muscle was noted (Figure 1).
MRI imaging showed: A - heterogeneous mass on T2W1; B - hemosinus was observed in the left sphenoid sinus.
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T2-weighted image (T2WI), and hypointensity on the T1-weighted image (T1WI), with prominent enhancement after contrast administration (Figure 2). The imaging findings were suggestive of glomangiopericytoma with panhemosinus.
Digital subtraction angiography revealed: A - vascular tumor blush in the left nasal cavity; B - supplied mainly by the left posterior ethmoidal artery.
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The main feeder of the blush was from the left ophthalmic artery branches (anterior and posterior ethmoidal arteries) (Figure 3).
Photomicrographs of the tumor. A - subepithelial unencapsulated tumor proliferation separated from the surface of the respiratory epithelium by a grenz zone (H&E, 100X); B - glomangiopericytoma cells are bland oval and spindle, arranged in short fascicles around staghorn blood vessels (H&E, 400X); C - positive immunohistochemical stainings for smooth muscle actin (400X); D - immunohistochemical stainings for cyclin D1 (400X).
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Immunohistochemically, the tumor cells were positive to smooth muscle actin, cyclin D1 and beta-catenin (Figures 4C, 4D and Figure 5), but negative to pancytokeratin, synaptophysin, chromogranin, S100, desmine, caldesmon, EMA, STAT6, and CD34.
Photomicrograph of the tumor. Positive perinuclear staining for beta-catenin was observed in the majority of tumor cells (x400).
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Immunohistochemically, the tumor cells were positive to smooth muscle actin, cyclin D1 and beta-catenin (Figures 4C, 4D and Figure 5), but negative to pancytokeratin, synaptophysin, chromogranin, S100, desmine, caldesmon, EMA, STAT6, and CD34.