Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taiwan.
World J Surg Oncol. 2010 Mar 30;8:24. doi: 10.1186/1477-7819-8-24.
Carcinoma ex pleomorphic adenoma (CXPA) is an aggressive salivary gland malignancy and rare in minor salivary gland. A soft palate CXPA initially presenting as direct cavernous sinus (CS) invasion is very rare.
A 60-year-old male had a 3-month history of a small soft palatal mass with progressing left cheek numbness, proptosis, and disturbed vision. Biopsy of soft palatal tumor showed pleomorphic adenoma. Magnetic resonance imaging showed a tumor involving left maxilla, and extended from pterygopalatine fossa, inferior orbital fissure to CS. Excision of tumor revealed CXPA. Adjuvant concomitant chemo-radiation therapy (CCRT) was given. The tumor recurred 5 months later in left CS which was re-treated with CCRT. The disease status was stable at 2 years after the diagnosis of CXPA.
We present this case to emphasize that patients with symptoms such as facial numbness, proptosis and disturbed vision should be carefully investigated for lesions invading CS by perineural spread.
癌型多形性腺瘤（Carcinoma ex pleomorphic adenoma，CXPA）是一种侵袭性的唾液腺癌，在小唾液腺中较为罕见。原发于软腭且最初表现为直接侵犯海绵窦的 CXPA 则更为罕见。
一名 60 岁男性，3 个月前出现软腭小肿块，左侧面颊麻木、眼球突出和视力障碍逐渐加重。软腭肿瘤活检显示为多形性腺瘤。磁共振成像显示肿瘤累及左侧上颌骨，从翼腭窝、下眶裂延伸至海绵窦。肿瘤切除后显示为 CXPA。给予辅助同步放化疗（CCRT）。5 个月后，肿瘤在左侧海绵窦复发，再次接受 CCRT 治疗。诊断为 CXPA 后 2 年，疾病状况稳定。
我们报告此病例强调，出现面部麻木、眼球突出和视力障碍等症状的患者，应通过神经周围扩散仔细检查是否有侵犯海绵窦的病变。
