Pleomorphic adenoma of nasal septum: a rare case

Abstract

The most common benign tumour of the major salivary glands is the pleomorphic adenoma. They are seen rarely in the minor salivary glands, usually in hard palate, soft palate and nasopharynx. Pleomorphic adenomas in nasal cavity are unusual and may be misdiagnosed because they have predominant myoepithelial cellularity and fewer myxoid stromata compared with those elsewhere. We present a case of 38-year-old male with a 2-year history of left nasal obstruction and epistaxis since 6 months. Diagnostic nasal endoscopic examination showed a soft lobulated mass in left nasal cavity attached to anterior part of the septum. Radiological examination demonstrated soft tissue mass filling left nasal cavity with an eroded septum. The biopsy from the mass was suggestive of pleomorphic adenoma and was resected endoscopically. Histopathological examination was consistent with pleomorphic adenoma. These are rare tumours of the nasal cavity and can be managed effectively with the endoscopic approach.

A Large Pleomorphic Adenoma in Nasal Cavity Misdiagnosed as Inverted Papilloma

“…In contrast, endoscopic resection of a large PANC has been challenging. Several authors have described endoscopic-wide excisions of a massive PANC 2,4,11,12 . In our case, endoscopic resection was performed using a microdebrider with a clear safety margin.…”

“…In addition, PANC should also be clinically distinguished from aggressive epithelial tumors, such as carcinoma 5 . Typical H&E findings of PANC include epithelial cells mixed with interspersed mesenchymal element 4 . On immunohistochemistry, positivity for CK is a marker for epithelial components including salivary gland tumors 2 .…”

“…Pleomorphic adenoma (PA) is known as a slowly-growing mixed tumor; thus, its symptoms appear after a long silent period. 4 Clinical manifestations include unilateral nasal obstruction, intermittent epistaxis, rhinorrhea, epiphora, nasal pain, and facial swelling. 5 PANC presents in the middle age, with a female preponderance.…”

“…Pathologically, PANC is composed of epithelial components than myxoid stromal components compared with that of PA in other locations. 4 The mixture of different cellularity in PANC is similar to that of a sinonasal inverted papilloma (SNIP), which is characterized by an exophytic proliferation with pronounced endophytic downward growth composed of interconnected islands of epithelial cells. 6 Sinonasal papilloma is the most common benign tumor in the sinonasal area and can sometimes be associated with squamous cell carcinoma.…”

Endoscopic management of huge pleomorphic adenoma of the nasal septum; a case report

“…Leiomyoma, haemangioma, osteochondroma, papilloma, melanoma, adenoid cystic carcinoma, and squamous cell carcinoma are some of the benign and malignant lesions that can develop on the nasal septum [ 2 ]. The pleomorphic adenoma of nasal septum is a rare tumor [ 3 ]. This paper presents a 72-year lady with a pleomorphic adenoma of the nasal septum which has obstructed the bilateral nasal cavity for two years which is look like hemangioma and successfully removed with endoscopic endonasal approach with microdebrider.…”