Salivary gland tumors are rare among all head and neck tumors. Pleomorphic adenoma (PA) is the most commonly seen subtype, and 85% of the cases are located in the parotid gland. PA may very rarely be seen in minor salivary glands. Minor salivary gland PAs are mostly located in the hard and soft palates. Nasopharyngeal PA is very rare, and a total of 8 cases have been published to date. In this case report, a 51-year-old female patient who had nasopharyngeal PA with chondroid metaplasia is presented, and we review the relevant literature.
Salivary gland tumors are rare and constitute less than 5% of all head and neck tumors [
A 51-year-old female patient came to our clinic with postnasal drainage and intermittent nasal obstruction. Oropharynx examination was normal. There were no features on anterior rhinoscopic examination. On nasopharyngeal endoscopic examination, there was an approximately 1 × 1 cm mass with a smooth surface on the posterior wall of the nasopharynx (Figure
Preoperative nasopharyngeal endoscopy. The nasopharynx is seen in the posterior wall with a stalk-shaped mass and a 1 × 1 cm mass lesion.
Pathologic specimen image. Pleomorphic adenoma showing chondroid metaplasia (10 H&E).
Postoperative 1st year image after punch biopsy. There was no significant difference between this and the appearance in the early postoperative period.
When a nasopharyngeal mass is detected in an adult patient, nasopharyngeal malignancy is usually suspected. Most common types of nasopharyngeal cancer are keratinising squamous cell carcinoma, nonkeratinising carcinoma, and basaloid squamous cell carcinomas [
PAs are the most common salivary gland tumors and comprise 45–70% of all salivary gland tumors [
PA is typically located in the parotid lower pole or the superficial lobe. Deep lobe localization is rare [
Nasopharyngeal PA is seen very rarely. According to the sources available to us, there have been only 8 cases reported in the literature [
Nasopharyngeal pleomorphic adenoma cases in the literature.
Age | Sex | Treatment | Follow-up duration (months) | Recurrence | Multiple location | Complaint | Size (cm) | Malignancy | |
---|---|---|---|---|---|---|---|---|---|
Ryu et al. [ |
57 | M | Surgery | 12 | No | No | Nasal obstruction | 3.3 | SCC |
Ryu et al. [ |
37 | M | Surgery | 6 | No | No | SOM | 3.5 | SCC |
Lee et al. [ |
78 | M | Surgery | 20 | No | No | Tinnitus, SOM | N/A | No |
Furukawa et al. [ |
51 | F | Surgery + RT | 20 | No | No | Nasal obstruction | N/A | SCC |
Berrettini et al. [ |
51 | F | Surgery | 6 | No | No | Nasal obstruction | 4 | No |
Martínez-Capoccioni et al. [ |
52 | F | Surgery | 52 | No | No | SOM | 2 | No |
Maruyama et al. [ |
80 | F | Surgery | 24 | No | No | SOM | 2 | No |
Yazıcı et al. [ |
62 | M | Surgery | 12 | No | No | SOM | 2 | No |
Current case | 51 | F | Surgery | 12 | No | No | Nasal obstruction | 1 | No |
SCC: squamous cell carcinoma; SOM: serous otitis media; RT: radiotherapy; M: male; F: female.
Pleomorphic adenoma-related squamous cell carcinoma (SCC) has been detected in 3 of 8 cases published in the literature [
Surgical procedures such as lateral rhinotomy and transnasal endoscopic approaches used for the other nasopharyngeal benign tumors can be used for this mass [
In conclusion, very rarely seen nasopharyngeal PAs should be kept in mind in the differential diagnosis of nasopharyngeal masses. The gold standard for treatment of PA is total surgical excision of the mass.
This study was presented in the 40th Turkish National Otorhinolaryngology and Head and Neck Surgery Congress, 7th-11th December, 2018, Antalya, Turkey.
The authors declare that they have no conflicts of interest.