Objective: To report a case of a pleomorphic adenoma of the minor salivary gland, with an unusual presentation as an intranasal and palatal mass its clinical manifestations, differential diagnosis, prognosis and management options.
Study design: Case report
Setting: Tertiary hospital
Case Report: This is a case of a 58-year old male who presented with a 12-year history of an enlarging left intranasal and palatal mass. On physical examination, a smooth fleshy mass completely obliterates the left nostril, deviating the septum to the right. Oral cavity revealed a 5x5cms smooth, firm, non-tender mass on the hard palate. Fine needle aspiration biopsy of the palatal mass yielded 4 cc of sero-sanguinous fluid suggestive of hemangioma. PNS CT scan demonstrated a large nasopharyngeal mass extending to both maxillary sinuses with associated bony destruction. Through a modified Weber-Ferguson incision, the tumor was seen attached to the nasal septum extending up to the hard palate. After ligating the left external carotid artery to control bleeding, the tumor was excised via a left maxillectomy to achieve a wide local resection. Histopath revealed pleomorphic adenoma. At present, 2 years after resection, the patient has had no further problems and repeat nasal endoscopic examination revealed no recurrence.
Conclusion: Pleomorphic adenomas are rare tumors of the minor salivary glands and are even more unusual if found in the nasal cavity and the palate. In cases of unilateral nasal obstruction, intranasal pleopmorphic adenoma should be considered in the differential diagnosis. Wide excision ensures good prognosis. However, recurrence may occur if there are inadequate margins.