Nasal Cavity Glomangiopericytoma: A Diagnostic Challenge and Surgical Management Insights

Background: Glomangiopericytoma, a rare sinonasal tumor arising from pericytes, represents less than 0.5% of sinonasal neoplasms.Its nonspecific symptoms, such as epistaxis and nasal obstruction, often lead to misdiagnosis as sinusitis or nasal polyps. Diagnosis relies on imaging (CT/MRI) and histopathological analysis with immunohistochemistry (SMA, beta-catenin positivity). Endoscopic surgical resection is the primary treatment, with recurrence rates of 10-40% necessitating long-term follow-up. Case Report: A 43-year-old woman presented with recurrent nasal bleeding and vomiting, initially managed as sinusitis and inflammatory arthritis. Prior septoplasty provided no relief. CT revealed a right nasal cavity mass with septal erosion, and functional endoscopic sinus surgery (FESS) identified a polypoidal lesion. Histopathology and immunohistochemistry confirmed glomangiopericytoma (SMA, betacatenin positive). MRI showed a 2.7 cm lesion with ethmoid sinus involvement. Definitive endoscopic resection achieved clear margins, with no postoperative complications. Follow-up endoscopy showed no recurrence. Conclusion: This case highlights the diagnostic challenges of glomangiopericytoma due to its atypical presentation mimicking sinusitis and arthritis. Thorough imaging, histopathological confirmation, and multidisciplinary management are critical for accurate diagnosis. Endoscopic resection proved effective, offering minimal morbidity and a favourable prognosis. Long-term surveillance is essential due to recurrence risks, emphasizing the importance of comprehensive surgical and follow-up strategies in managing this rare sinonasal tumor.