Gana Polycarp, Masterson Liam
ENT Department, Edith Cavell Hospital, Bretton Gate, Peterborough, UK.
J Med Case Rep. 2008 Nov 17;2:349. doi: 10.1186/1752-1947-2-349.
Pleomorphic adenomas are the most common benign tumour of the major salivary glands. In addition, they may also occur in the minor salivary glands of the hard and soft palate. Intranasal pleomorphic adenomas are unusual and may be misdiagnosed because they have greater myoepithelial cellularity and fewer myxoid stromata compared to those elsewhere.
We present the case of a 61-year-old man who presented with a 2-year history of left nasal obstruction, occasional epistaxis and facial pain. Radiological examination demonstrated well pneumatised paranasal sinuses and a soft tissue mass in the anterior aspect of the left nasal cavity. In this patient, an intranasal approach was used to achieve a wide local resection.
Pleomorphic adenomas are rare tumours of the nasal cavity and have been shown to be misdiagnosed in over half of cases leading to more aggressive treatment than is necessary. If unilateral nasal obstruction is the main presenting complaint, we suggest consideration of this diagnosis. In view of the potential for tumour recurrence, long-term follow-up and careful examination of the nose with an endoscope are necessary.
多形性腺瘤是大唾液腺最常见的良性肿瘤。此外,它们也可能发生于硬腭和软腭的小唾液腺。鼻内多形性腺瘤较为罕见,且可能被误诊,因为与其他部位的多形性腺瘤相比,其肌上皮细胞更多,黏液样基质更少。
我们报告一例61岁男性患者,有2年左侧鼻塞、偶尔鼻出血及面部疼痛病史。影像学检查显示鼻窦气化良好,左侧鼻腔前部有一软组织肿块。该患者采用鼻内入路进行广泛局部切除。
多形性腺瘤是鼻腔罕见肿瘤,已证实超过半数病例被误诊,导致进行了不必要的更积极治疗。如果主要症状是单侧鼻塞,我们建议考虑这一诊断。鉴于肿瘤有复发可能,需要长期随访并通过鼻内镜仔细检查鼻腔。