上咽頭に発生した多形腺腫例

抄録

A 63-year-old woman visited a neighborhood ENT doctor with an approximately 6-month history of blocked nose on the left side. The ENT doctor referred her to our hospital with suspicion of a lesion in the nasopharynx. Nasal endoscopic examination at our hospital revealed a yellow-white to dark-red sessile polypoid lesion with a smooth surface in the left nasopharynx as the cause of the left nasal obstruction.

Contrast-enhanced CT showed absence of any bone destruction associated with the tumor of the left nasopharynx. MRI examination with contrast injection showed possible infiltration of the surrounding soft tissue by the tumor. On PET/CT examination, the maximum SUV was 3.7, and no evidence of metastasis to the cervical lymph nodes or distant metastasis was recognized. The initial biopsy revealed the possibility of hemangiopericytoma, and a second biopsy was performed, which also failed to reveal a definitive diagnosis. Therefore, we performed a third biopsy under local anesthesia to obtain a definitive diagnosis, which confirmed the diagnosis of pleomorphic adenoma. The tumor was resected by nasal endoscopic sinus surgery under general anesthesia 3 weeks after the last biopsy. With the preoperative diagnosis of plemorphic adenoma, the tumor was resected with a sufficient margin owing to the possibility of infiltration of the surrounding soft tissues by the tumor and extracapsular invasion. At present, 3 years after the surgery, the patient remains under follow-up and has shown no evidence of any recurrence of the tumor.