Thakur J S, Saluja Manika, Sharma Dev Raj, Mohindroo N K
Department of Otolaryngology and Head and Neck Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
BMJ Case Rep. 2013 Feb 25;2013:bcr2013008794. doi: 10.1136/bcr-2013-008794.
Nasopharyngeal fibrolipoma is extremely rare, with only four case reports in the literature. However, lipoma of the eustachian tube is the rarest with a single case report in the literature. A 50-year-old woman presented with obstruction of both nostrils for the past 1 year. CT scan showed a mass in the postnasal space extending from the right side of the nasopharynx to the oropharynx. The nasal endoscopy found a polypoidal mass arising from the posterior-inferior margin of the right eustachian tube ostium and extending to the oropharynx. Histopathological examination of the excised polyp found features suggestive of fibrolipoma. Fibrolipoma is characterised by prominent bundles of mature collagenous or myxocollagenous stroma intermixed with mature adipocytes. CT is useful in the diagnosis of lipoma but MRI is preferable. This is the second case of eustachian tube fibrolipoma to be reported in the literature that emphasises the role of nasal endoscopy and rarity of this tumour.
鼻咽纤维脂肪瘤极为罕见,文献中仅有4例病例报告。然而,咽鼓管脂肪瘤最为罕见,文献中仅有1例病例报告。一名50岁女性在过去1年中出现双侧鼻孔阻塞。CT扫描显示鼻后间隙有一肿块,从鼻咽右侧延伸至口咽。鼻内镜检查发现一个息肉样肿块,起源于右咽鼓管开口的后下缘并延伸至口咽。对切除的息肉进行组织病理学检查发现有提示纤维脂肪瘤的特征。纤维脂肪瘤的特点是有突出的成熟胶原或黏液胶原基质束与成熟脂肪细胞混合。CT对脂肪瘤的诊断有用,但MRI更佳。这是文献中报道的第二例咽鼓管纤维脂肪瘤病例,强调了鼻内镜检查的作用以及该肿瘤的罕见性。