Pleomorphic adenoma of the nasal septum —a case report—

Abstract

Pleomorphic adenomas most commonly arise in the major salivary glands, and only rarely in the nasal cavity. We report a case of pleomorphic adenoma originating from the nasal septum. A 66-year-old woman complained of nasal obstruction. Endoscopic examination revealed a tumor in the left nasal cavity that was covered with smooth mucosa and showed vasodilatation. Computed Tomography showed an enhanced round mass in the left nasal cavity. Magnetic Resonance Imaging showed no infiltration of the tumor. We performed a biopsy before excision, and perioperative pathology led to a diagnosis of spindle cell carcinoma. We were able to observe the tumor intranasally, so decided on endoscopic sinus surgery. Taking into consideration the fact that it was a spindle cell carcinoma, we established sufficient margins of safety. We resected the perpendicular plate and mucosa of the right nasal septum together with the tumor using a CO2 laser. The tumor was 20 × 25mm in diameter, and consisted of a white solid mass. Pathologically, it was diagnosed as a Pleomorphic adenoma of the nasal septum. There has been no recurrence at 9 months. Case of pleomorphic adenoma of the nasal cavity have characteristics unlike those of major salivary gland adenomas in that symptoms such as nasal obstruction and epistaxis appear early, and sufficient resection is possible. The treatment of choice for pleomorphic adenoma is resection. In cases involving the nasal cavity, this can be done either by intranasal or extranasal surgery, according to the type, size and location of the tumor.