Abstract
BackgroundCarcinoma ex pleomorphic adenoma (CXPA) is an aggressive salivary gland malignancy and rare in minor salivary gland. A soft palate CXPA initially presenting as direct cavernous sinus (CS) invasion is very rare.Case PresentationA 60-year-old male had a 3-month history of a small soft palatal mass with progressing left cheek numbness, proptosis, and disturbed vision. Biopsy of soft palatal tumor showed pleomorphic adenoma. Magnetic resonance imaging showed a tumor involving left maxilla, and extended from pterygopalatine fossa, inferior orbital fissure to CS. Excision of tumor revealed CXPA. Adjuvant concomitant chemo-radiation therapy (CCRT) was given. The tumor recurred 5 months later in left CS which was re-treated with CCRT. The disease status was stable at 2 years after the diagnosis of CXPA.ConclusionWe present this case to emphasize that patients with symptoms such as facial numbness, proptosis and disturbed vision should be carefully investigated for lesions invading CS by perineural spread.
Highlights
Carcinoma ex pleomorphic adenoma (CXPA) is an aggressive salivary gland malignancy and rare in minor salivary gland
We present this case to emphasize that patients with symptoms such as facial numbness, proptosis and disturbed vision should be carefully investigated for lesions invading cavernous sinus (CS) by perineural spread
We describe a 60-year-old male diagnosed as a CXPA of the soft palate with direct cavernous sinus (CS) invasion
Summary
Carcinoma ex-pleomorphic adenoma (CXPA) is a rare, aggressive, poorly understood malignancy that usually develops in a primary or recurrent pleomorphic adenoma (PA) [1]. The initial presentations of his disease were left cheek numbness, proptosis and blurred vision which were rarely reported in the literature [5]. Physical examinations of the head and neck revealed an area of numbness in the distribution of 2nd division of trigeminal nerve, proptosis, and disturbed visual acuity at the level of counting fingers. He had left esotropia which was due to traumatic left abducens nerve palsy by saw dust 10 months ago. Magnetic resonance imaging (MRI) arranged revealed irregular soft tissue mass involving left maxilla, and extended from pterygopalatine fossa, inferior orbital fissure to CS with bony destruction of the skull base (Figure 2).
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
