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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.

References

Haerle, SK, Gullane, PJ, Witterick, IJ, Zweifel, C, Gentili, F. Sinonasal carcinomas: epidemiology, pathology, and management. Neurosurg Clin N Am 2013;24:39–49CrossRefGoogle Scholar
Mahalingappa, YB, Khalil, HS. Sinonasal malignancy: presentation and outcomes. J Laryngol Otol 2014;128:654–7CrossRefGoogle ScholarPubMed
Lund, VJ, Clarke, PM, Swift, AC, McGarry, GW, Kerawala, C, Carnell, D. Nose and paranasal sinus tumours: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130(suppl 2):S111–18CrossRefGoogle ScholarPubMed
Nygren, A, Kiss, K, von Buchwald, C, Bilde, A. Rate of recurrence and malignant transformation in 88 cases with inverted papilloma between 1998–2008. Acta Otolaryngol 2016;136:333–6CrossRefGoogle ScholarPubMed
Dragonetti, A, Gera, R, Sciuto, A, Scotti, A, Bigoni, A, Barbaro, E et al. Sinonasal inverted papilloma: 84 patients treated by endoscopy and proposal for a new classification. Rhinology 2011;49:207–13CrossRefGoogle ScholarPubMed
Yue, D, Feng, W, Ning, C, Han, LX, YaHong, L. Myoepithelial carcinoma of the salivary gland: pathologic and CT imaging characteristics (report of 10 cases and literature review). Oral Surg Oral Med Oral Pathol Oral Radiol 2017;123:e182–7CrossRefGoogle Scholar
Hiwatashi, A, Matsumoto, S, Kamoi, I, Yamashita, H, Nakashima, A. Imaging features of myoepithelioma arising from the hard palate: a case report. Acta Radiol 2000;41:417–19Google ScholarPubMed
Monzen, Y, Fukushima, N, Fukuhara, T. Myoepithelioma and malignant myoepithelioma arising from the salivary gland: computed tomography and magnetic resonance findings. Australas Radiol 2007;51:B169–72CrossRefGoogle ScholarPubMed
Lee, DH, Jung, SH, Yoon, TM, Lee, JK, Joo, YE, Lim, SC. Low grade chondrosarcoma of the nasal septum. World J Clin Cases 2013;1:64–6CrossRefGoogle ScholarPubMed
Rahimi, A, Beabout, JW, Ivins, JC, Dahlin, DC. Chondromyxoid fibroma: a clinicopathologic study of 76 cases. Cancer 1972;30:726–363.0.CO;2-T>CrossRefGoogle ScholarPubMed
Veras, EFT, Santamaria, IB, Luna, MA. Sinonasal chondromyxoid fibroma. Ann Diagn Pathol 2009;13:41–6CrossRefGoogle ScholarPubMed
Kang, JW, Im, SK, Song, CE, Jung, SY. A nasal myoepithelioma removed through preoperative embolization and endoscopic surgery: a case report and literature review. Korean J Otorhinolaryngol Head Neck Surg 2019;62:747–54CrossRefGoogle Scholar
Sayed, SI, Kazi, RA, Jagade, MV, Palav, RS, Shinde, VV, Pawar, PV. A rare myoepithelioma of the sinonasal cavity: case report. Cases J 2008;1:29CrossRefGoogle ScholarPubMed
Cunha, G, Camurugy, T, Cavalcante Ribeiro, T, Costa, N, Azevedo, A, Vinhaes, E et al. Myoepithelioma of the nasal septum: a rare case of extrasalivary gland involvement. Case Rep Otolaryngol 2017;2017:7057989Google ScholarPubMed
Jafarian, AH, Omidi, AA, Roshan, NM, Montazer, M, Joushan, B. Recurrent extensive plasmacytoid myoepithelioma of the sinonasal cavity: a case report. J Res Med Sci 2012;17:979–82Google Scholar
Bist, SS, Varshney, S, Baunthiyal, V, Bhagat, S, Kusum, A. Clinico-pathological profile of sinonasal masses: an experience in tertiary care hospital of Uttarakhand. Natl J Maxillofac Surg 2012;3:180–6CrossRefGoogle ScholarPubMed