Intranasal mixed tumors (pleomorphic adenomas): a clinicopathologic study of 40 cases

The clinical, gross, and microscopic features of 40 cases of intranasal mixed tumor (pleomorphic adenoma) are reviewed and studied. The majority of these neoplasms originate from the mucosa of the bony or cartilaginous septum; they also occur on the lateral nasal wall. They may be found at any age, but the majority of our cases occurred in persons in the third through sixth decades of life. There was no significant sex predilection. All patients whose race was recorded (35) were Caucasian. The patients commonly had symptoms of nasal obstruction or the presence of a mass in the nasal cavity, or both. Clinically, the lesions were not unique, frequently being described only as polypoid, broad-based swellings. Microscopically, although similar to mixed tumors of major salivary glands, these tumors differed by being highly cellular (epithelial), with little or no stromal component, and thus simulated more aggressive epithelial neoplasms. Follow-up data (mean 7.5 years) in 34 of the 40 cases showed no evidence to suggest aggressive behavior. Thirty-one of the 34 cases followed showed no recurrence, regardless of the type of excisional procedure used. Those that did recur were either persistent from inadequate primary excisions (2 cases) or recurred locally (1) and were removed without sequelae. Local but adequate excision appears to be the treatment of choice.