A Rare Case of Nasopharyngeal Pleomorphic Adenoma

Salivary gland tumors are rare. The majority of these tumors are benign and about 70% are pleomorphic adenomas (PA). Nasopharynx is an unusual site for the PA tumor. Only six cases are presented in the literature from 1990 to 2011. The diagnosis of this disease is linked to the sum of imaging tests, clinical and histological study of the mass of the above. The radiologic features of noninvasion of surrounding structures give the first clue to the benign lesion. From the review of the literature and our experience is identified as the gold standard in surgical treatment for this condition. Thanks to the endoscopic surgery, we can perform a complete resection of the lesion without damaging adjacent structures. We presented a case of pleomorphic adenoma of nasopharynx with literature review. 1. Introduction Salivary gland tumors are rare, with less than 5% of all head and neck neoplasms forming in the salivary gland, commonly in the parotid [1]. The majority of these tumors are benign and about 70% are pleomorphic adenomas (PA). It mainly occurs in the parotid gland and submandibular gland. If the tumor occurs in the minor salivary glands, the most common site is the palate, [2] but this tumor can also occur in other sites including the upper lip, cheek, pharynx, floor of the mouth, larynx, and trachea. The first site of origin in nasopharynx is extremely rare [3, 4]. The aim of this paper is to present a case of PA of the nasopharynx. Moreover, we report a literature review that reveals only six cases like the present one. 2. Case Report A 51-year-old woman was referred to us with a progressive nasal obstruction associated left aural fullness and pain with a middle conductive hearing loss. The symptoms arose two years before. In home hospital, the patient has been already evaluated with a Magnetic Resonance. These imaging tests showed a mass connected to the lateral wall of nasopharynx space. The lesion does not infiltrate the adjacent tissue and had lobed margins. The radiologist retained that the images were assimilable to pleomorphic adenoma (Figure 1). The chemoradiotherapy was the first choice treatment but the tumor did not drop and the symptoms worsened. Figure 1: Magnetic Resonance. A mass connected to the lateral wall of nasopharynx space is identified. The lesion does not infiltrate the adjacent tissue and had lobed margins. In our hospital, on endoscopic examination the lesion appears as a soft whitish mass of ？cm; it took up the entire nasopharynx. We performed a biopsy in order to obtain a definitive histological evaluations. The result