Thakur Jagdeep S, Mohindroo Narinder K, Mohindroo Shobha, Sharma Dev R, Thakur Anamika
Department of Otolaryngology - Head & Neck Surgery, I. G. Medical College, Shimla, HP, 171001, India.
BMC Ear Nose Throat Disord. 2010 Jan 8;10:2. doi: 10.1186/1472-6815-10-2.
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.
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.
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.
鼻咽部良性肿瘤是耳鼻咽喉科中最少见的肿瘤,因为鼻咽部被认为是恶性肿瘤的高发解剖部位之一。鼻咽部及咽旁间隙小涎腺多形性腺瘤罕见。我们报告一例小涎腺多形性腺瘤误诊病例。
一名成年男性因左侧鼻塞5个月就诊。检查发现有一巨大肿物从鼻咽部延伸至口咽部。CT扫描显示该肿瘤体积较大并延伸至咽旁间隙。细针穿刺抽吸活检(FNAB)结果提示为癌,但该肿瘤对放疗无反应。肿瘤切除活检显示为多形性腺瘤。我们仅发现5篇关于起源于鼻咽部的该肿瘤的文献报道。
尽管在本病例报告中,由于肿瘤似乎也起源于咽旁间隙,无法确切确定肿瘤的起源,但基于临床特征,我们仍考虑为鼻咽部肿瘤。鼻咽部多形性腺瘤罕见。在组织病理学上,它可能被误诊为恶性上皮性肿瘤。与恶性变体的鉴别也很困难。对于无转移证据的鼻咽部肿物,应始终考虑良性肿瘤的可能性,并且在进行任何确定性治疗之前应获得肿物的组织病理学诊断。