Carcinoma ex Pleomorphic Adenoma of the Nasal Cavity
- 142 Downloads
Carcinoma ex pleomorphic adenoma (CXPA) is a malignant epithelial neoplasm arising in a benign mixed tumor (i.e., pleomorphic adenoma or PA); it accounts for approximately 3–4% of all salivary gland neoplasms. CXPA is exceedingly rare in the nasal cavity, with only three cases previously documented.
We report two cases of women presenting with masses of the nasal cavity. The tumors were resected and evaluated grossly and by routine microscopy.
Both patients presented with nasal obstruction, and one patient reported epistaxis. Grossly, the tumors were 2.5 and 3 cm in greatest dimension, respectively. In each case, microscopic examination of the tumor revealed an infiltrating carcinoma arising in association with foci of benign PA. The carcinoma types were adenoid cystic carcinoma and high grade adenocarcinoma, not otherwise specified. Both cases were widely (i.e., >1.5 mm) invasive beyond the preexisting PA. The findings were diagnostic of CXPA.
Carcinomatous transformation of a PA in the nasal cavity is extremely rare, but does occur. Accordingly, PAs of this site should be thoroughly sampled and closely examined to exclude the possibility of malignant transformation.
KeywordsCarcinoma ex pleomorphic adenoma Carcinoma ex mixed tumor Malignant mixed tumor Nasal cavity Nasal septum
- 1.Gnepp DR, Brandwein-Gensler M, El-Naggar AK, Nagao T. Carcinoma ex pleomorphic adenoma. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. World health organization classification of tumours: pathology and genetics of head and neck tumours. Lyon, France: IARC Press; 2005. pp. 242–243.Google Scholar
- 4.Eveson JW, Auclair PL, Gnepp DR, El-Naggar AK. Tumors of the salivary glands: Introduction. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. World health organization classification of tumours: pathology and genetics of head and neck tumours. Lyon, France: IARC Press; 2005. pp. 221–222. Google Scholar
- 7.Ellis GL, Auclair PL. Carcinoma ex pleomorphic adenoma. In: AFIP atlas of tumor pathology: tumors of the salivary glands. Vol 9, 4th ed. Washington, DC: ARP Press; 2008. pp. 259–269.Google Scholar
- 9.Brandwein M, Huvos AG, Dardick I, Thomas MJ, Theise ND. Noninvasive and minimally invasive carcinoma ex mixed tumor: a clinicopathologic and ploidy study of 12 patients with major salivary tumors of low (or no?) malignant potential. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81:655–64.PubMedCrossRefGoogle Scholar