Pleomorphic adenoma of minor salivary gland with therapeutic misadventure: a rare case report

An adult male presented with left nostril obstruction for five months. The examination found big mass extending from nasopharynx to oropharynx. On CT scan, this tumor was quite big and extending to the parapharyngeal space. The FNAB found it a carcinoma but it did not respond to radiotherapy. The excision biopsy of tumor revealed it as pleomorphic adenoma. We found only five published reports on this tumor arising from nasopharynx.Although, in this case report exact origin of the tumor could not be ascertained as it also appeared to be a parapharyngeal tumor but we kept the possibility of a nasopharyngeal tumor on the basis of clinical features. The pleomorphic adenoma of nasopharynx is rare. It can be misdiagnosed as malignant epithelial tumor on histopathology. The differentiation from its malignant variant is also difficult. A possibility of benign tumor should always be kept in nasopharyngeal growth with no evidence of metastasis, and histopathological diagnosis of growth should be available before any definitive treatment.Benign tumors of nasopharynx are rare since nasopharynx is a common site for malignant tumors. Pleomorphic adenoma is the most common benign tumor of the major and minor salivary glands, but rarely found in the nasopharynx. In this case report, we present a case of a large pleomorphic adenoma arising in the nasopharynx and extending to oropharynx that was diagnosed and managed as squamous cell carcinoma.In Sep 2007, a 35-year-old male presented with a progressive nasal obstruction associated with left aural fullness, hearing loss and hyponasal speech for the past five months. Later, the patient saw a mass pushing the soft palate downwards and began having difficulty in swallowing solid food. On examination, there was a mass behind and above the soft palate, which appeared to be arising from nasopharynx. Neck examination was found normal. Past history included a pyelolithotomy and gastrojujenostomy for duodenal ulcer.A fine needle aspiration bi