Sinonasal glomangiopericytoma presenting as refractory epistaxis: imaging, embolisation and pathological correlation

We describe a case of sinonasal glomangiopericytoma (GPC), a rare perivascular tumour accounting for less than 0.5% of sinonasal neoplasms, presenting with refractory unilateral epistaxis. An anticoagulated male in his 60s required admission, nasal packing and unilateral left internal maxillary artery embolisation to achieve haemostasis.

Following stabilisation, nasoendoscopy identified a vascular polypoid lesion arising high in the left nasal cavity near the olfactory cleft. MRI demonstrated a contrast-enhancing mass abutting the cribriform plate without orbital or skull-base invasion, which had not been recognised on prior imaging. Endoscopic biopsy confirmed GPC, followed by endoscopic resection at a tertiary skull-base centre.

Postoperative recovery was uncomplicated, with early resolution of epistaxis and safe recommencement of anticoagulation. However, the tumour was transected at the surgical margin, indicating incomplete or margin-uncertain excision and requiring close surveillance for residual or recurrent disease. This case highlights a rare cause of refractory unilateral epistaxis and illustrates the importance of diagnostic vigilance, multidisciplinary management and the potential role of embolisation in selected high-risk patients.