Pleomorphic adenoma of the nasal septum - A rare entity

Pleomorphic adenoma (PA) is the most common benign tumor of major salivary glands, and it rarely arises in minor salivary glands. PA has been reported at various sites where minor salivary glands are found and include nasal cavity, nasopharynx, pharynx, larynx, hypopharynx, and even lacrimal glands. We report one such a case in the nasal cavity in a middle-aged woman. The patient presented with nasal mass and symptoms of obstruction and epistaxis. After clinical and radiological evaluation, the mass was excised endoscopically, and histopathological examination revealed a biphasic benign cellular tumor with scant hyalinized stroma. On immunohistochemistry, the tumor was diffusely positive for CK7 and focally positive for P40 and smooth muscle actin (SMA). Proliferation index was 2%-3%. Finally, the diagnosis of PA was rendered. PA is generally restricted to the cavity due to paucity of space and presents early in the course. Surgical excision with wide margins is the treatment of choice. There are chances of recurrences and malignant transformation of the tumor. To conclude, although rare, one should consider a possibility of PA in the differentials of nasal masses, and accurate diagnosis of this entity is essential to ensure follow-up as recurrence and malignant transformation are reported in PA.