Transnasal endoscopic resection of a nasopharyngeal pleomorphic adenoma: a rare case report

Abstract

Pleomorphic adenoma (PA) is the most common benign tumor of the major and minor salivary glands, but rarely found in the nasopharynx. A PA originating from the left lateral wall of the nasopharynx was found in a 52-year-old female who presented with nasal obstruction, left-side otalgia, aural fullness, tinnitus and subjective hearing loss. It was successfully removed by transnasal endoscopic surgery (TES) and navigator system assessed our location, due to the proximity of critical anatomic structures such as the left internal carotid. We believe that the TES for primary and recurrent nasopharyngeal benign tumors is feasible and safe in properly selected patients, due to superior functional and cosmetic results and a low complication rate. Tumor characteristics and location should be taken into account when selecting cases for the right procedure for this lesions; transnasal endoscopic surgery is safe and preferable, carrying less potential morbidity compared to open procedures.

An endonasal approach to the resection of a papillary seromucinous adenocarcinoma of the Eustacian tube

“…Salivary gland tumors account for less than 5% of head and neck neoplasms and typically present in the oral cavity [4]. The likelihood of finding malignant rather than benign disease in a salivary gland tumor increases as the size of the gland of origin decreases [5].…”

Management of Pleomorphic Adenoma in the Nasopharynx: A Case Report

“…Complications like bleeding and Eustachian tube dysfunction after operation can occur and are usually due to blind resection. For nasopharyngeal PAs, the rate of malignant degeneration is not known exactly, but degeneration to carcinoma ex pleomorphic adenoma were reported in some case reports (3).…”

Misdiagnosis of a Nasopharyngeal Pleomorphic Adenoma as a Nasopharyngeal Carcinoma

“…They are sometimes difficult to distinguish from low-grade malignancies or other benign neoplasms and clinical findings in exploration and endoscopy should support the image findings [6].…”

“…In this case, previous radiotherapy should lead to intraoperative bleeding, delayed scar formation, ulceration or necrosis with a subsequent bleeding risk and that is why an endoscopic sphenopalatine artery ligation was performed prior to excision of the tumor. Long term follow-up is necessary for early diagnosis of any sign of recurrence [4][5][6].…”