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Pleomorphic adenoma of minor salivary gland with therapeutic misadventure: a rare case report.

Thakur JS, Mohindroo NK, Mohindroo S, Sharma DR, Thakur A - BMC Ear Nose Throat Disord (2010)

Bottom Line: The examination found big mass extending from nasopharynx to oropharynx.The FNAB found it a carcinoma but it did not respond to radiotherapy.A possibility of benign tumor should always be kept in nasopharyngeal growth with no evidence of metastasis, and histopathological diagnosis of growth should be available before any definitive treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otolaryngology - Head & Neck Surgery, I. G. Medical College, Shimla, HP, 171001, India.

ABSTRACT

Background: The benign tumors of nasopharynx are least encountered tumors in otolaryngology, as nasopharynx is considered one of notorious anatomical site for the malignant tumors. Pleomorphic adenoma of the minor salivary gland of nasopharynx and parapharyngeal space is rare. We present a pleomorphic adenoma of minor salivary gland which was mismanaged.

Case presentation: An adult male presented with left nostril obstruction for five months. The examination found big mass extending from nasopharynx to oropharynx. On CT scan, this tumor was quite big and extending to the parapharyngeal space. The FNAB found it a carcinoma but it did not respond to radiotherapy. The excision biopsy of tumor revealed it as pleomorphic adenoma. We found only five published reports on this tumor arising from nasopharynx.

Discussion and conclusion: Although, in this case report exact origin of the tumor could not be ascertained as it also appeared to be a parapharyngeal tumor but we kept the possibility of a nasopharyngeal tumor on the basis of clinical features. The pleomorphic adenoma of nasopharynx is rare. It can be misdiagnosed as malignant epithelial tumor on histopathology. The differentiation from its malignant variant is also difficult. A possibility of benign tumor should always be kept in nasopharyngeal growth with no evidence of metastasis, and histopathological diagnosis of growth should be available before any definitive treatment.

No MeSH data available.


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Photomicrograph of pleomorphic adenoma showing epithelial component (marked as '1') consisting of acini, duct, sheets and cords, and mesenchymal component consisting of myxoid (marked as '2') and chondroid areas (marked as '3'). (H & E × 100).
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Figure 3: Photomicrograph of pleomorphic adenoma showing epithelial component (marked as '1') consisting of acini, duct, sheets and cords, and mesenchymal component consisting of myxoid (marked as '2') and chondroid areas (marked as '3'). (H & E × 100).

Mentions: A radiation oncologist evaluated the patient and investigations, and began radical chemo-radiation. However, the tumor did not regress despite receiving 20 Gray of radiation, and this led to a suspicion of a benign growth. On 25th March 2008, a fresh CT scan (Fig 2) was done and it showed nasopharyngeal tumor with same features as pre radiotherapy but increased considerably as compared to earlier CT scan. Since there was no histopathological evidence of the carcinoma, the intra-oral incisional biopsy was done and was found to be suggestive of a pleomorphic adenoma. A surgical intervention was planned, and tumor was excised by transpalatal approach under general anesthesia. Histological examination of the excised tumor confirmed a pleomorphic adenoma with no evidence of malignancy (Fig 3). The patient recovered well without any complication and had no recurrence in follow up of 1 year.


Pleomorphic adenoma of minor salivary gland with therapeutic misadventure: a rare case report.

Thakur JS, Mohindroo NK, Mohindroo S, Sharma DR, Thakur A - BMC Ear Nose Throat Disord (2010)

Photomicrograph of pleomorphic adenoma showing epithelial component (marked as '1') consisting of acini, duct, sheets and cords, and mesenchymal component consisting of myxoid (marked as '2') and chondroid areas (marked as '3'). (H & E × 100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2821363&req=5

Figure 3: Photomicrograph of pleomorphic adenoma showing epithelial component (marked as '1') consisting of acini, duct, sheets and cords, and mesenchymal component consisting of myxoid (marked as '2') and chondroid areas (marked as '3'). (H & E × 100).
Mentions: A radiation oncologist evaluated the patient and investigations, and began radical chemo-radiation. However, the tumor did not regress despite receiving 20 Gray of radiation, and this led to a suspicion of a benign growth. On 25th March 2008, a fresh CT scan (Fig 2) was done and it showed nasopharyngeal tumor with same features as pre radiotherapy but increased considerably as compared to earlier CT scan. Since there was no histopathological evidence of the carcinoma, the intra-oral incisional biopsy was done and was found to be suggestive of a pleomorphic adenoma. A surgical intervention was planned, and tumor was excised by transpalatal approach under general anesthesia. Histological examination of the excised tumor confirmed a pleomorphic adenoma with no evidence of malignancy (Fig 3). The patient recovered well without any complication and had no recurrence in follow up of 1 year.

Bottom Line: The examination found big mass extending from nasopharynx to oropharynx.The FNAB found it a carcinoma but it did not respond to radiotherapy.A possibility of benign tumor should always be kept in nasopharyngeal growth with no evidence of metastasis, and histopathological diagnosis of growth should be available before any definitive treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otolaryngology - Head & Neck Surgery, I. G. Medical College, Shimla, HP, 171001, India.

ABSTRACT

Background: The benign tumors of nasopharynx are least encountered tumors in otolaryngology, as nasopharynx is considered one of notorious anatomical site for the malignant tumors. Pleomorphic adenoma of the minor salivary gland of nasopharynx and parapharyngeal space is rare. We present a pleomorphic adenoma of minor salivary gland which was mismanaged.

Case presentation: An adult male presented with left nostril obstruction for five months. The examination found big mass extending from nasopharynx to oropharynx. On CT scan, this tumor was quite big and extending to the parapharyngeal space. The FNAB found it a carcinoma but it did not respond to radiotherapy. The excision biopsy of tumor revealed it as pleomorphic adenoma. We found only five published reports on this tumor arising from nasopharynx.

Discussion and conclusion: Although, in this case report exact origin of the tumor could not be ascertained as it also appeared to be a parapharyngeal tumor but we kept the possibility of a nasopharyngeal tumor on the basis of clinical features. The pleomorphic adenoma of nasopharynx is rare. It can be misdiagnosed as malignant epithelial tumor on histopathology. The differentiation from its malignant variant is also difficult. A possibility of benign tumor should always be kept in nasopharyngeal growth with no evidence of metastasis, and histopathological diagnosis of growth should be available before any definitive treatment.

No MeSH data available.


Related in: MedlinePlus