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A patient with a "good nose".

L Sze¹, C Fretz, G Hildebrandt

¹Division of Endocrinology and Diabetes, Kantonsspital St. Gallen, St. Gallen, Switzerland. lisa.sze@bluewin.ch

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|December 21, 2007

Summary

A nasopharyngeal mass in a man with cleft lip and palate was diagnosed as an ectopic pituitary gland, not a polyp. This case highlights the need for careful consideration before biopsy or excision of such tumors.

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Area of Science:

Endocrinology
Otorhinolaryngology
Neurosurgery

Background:

Dysphagia can be a challenging symptom to diagnose.
Nasopharyngeal masses require thorough investigation to determine their etiology.
Ectopic pituitary gland is a rare congenital anomaly.

Observation:

A 33-year-old man presented with dysphagia and was found to have a nasopharyngeal mass.
Initial assessments suggested a polyp or fibroma, leading to recommendations for biopsy or excision.
The patient had a history of cleft lip and palate, a key clinical feature.

Findings:

Thorough clinical and radiological re-examination led to the diagnosis of an ectopic pituitary gland.
The patient's refusal of invasive procedures likely prevented iatrogenic hypopituitarism.
This case underscores the importance of comprehensive evaluation for nasopharyngeal masses.

Implications:

Biopsy or excision of nasopharyngeal masses should be approached with caution.
Facial anomalies, such as cleft lip and palate, may be associated with ectopic pituitary glands.
Accurate diagnosis of nasopharyngeal masses is crucial to avoid unnecessary interventions and potential complications.