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Skull base pathology – a diagnostic conundrum

Published online by Cambridge University Press:  20 December 2021

H Devakumar Open the ORCID record for H Devakumar [Opens in a new window] ,
N Cereceda-Monteoliva ,
J Weir  and
M Ferguson
H Devakumar*
Affiliation:
Department of ENT, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
N Cereceda-Monteoliva
Affiliation:
Department of ENT, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
J Weir
Affiliation:
Department of Histopathology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
M Ferguson
Affiliation:
Department of ENT, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
*
Author for correspondence: Dr Haran Devakumar, ENT Department, Charing Cross Hospital, Fulham Palace Road, LondonSW7 2AZ, UK E-mail: [email protected]
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Abstract

Background

Myoepithelioma is a rare benign neoplasm, most commonly derived from salivary glands, but there are limited cases of extra salivary gland involvement too. There is little knowledge on typical investigative findings and, instead, diagnosis relies on immunohistochemistry analysis. To our knowledge, this paper reports the 13th case of sinonasal myoepithelioma in the English literature.

Case report

This paper presents a 25-year-old man who complained of chronic nasal obstruction. A sinonasal mass was noted on examination that appeared benign on imaging. Biopsy revealed a grade 2 chondrosarcoma that was endoscopically resected; however, excisional margins were positive. On histopathological review at the multidisciplinary team meeting, the lesion was more in keeping with chondromyxoid fibroma, but immunohistochemistry analysis confirmed a myoepithelioma lesion. In light of this revised diagnosis, quorate opinion was for follow up with active monitoring.

Conclusion

Sinonasal tumours require a thorough history, examination and investigation before a treatment plan can be formulated. If there is diagnostic uncertainty, it is important to keep a wide differential list and seek a second specialist opinion where possible.

Keywords

ChondrosarcomaMyoepithelioma
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 11 , November 2022 , pp. 1135 - 1138
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr H Devakumar takes responsibility for the integrity of the content of the paper

Presented at the Combined Otolaryngology Spring Meetings (‘COSM’), 7–11 April 2021, virtual event.

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