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Malignant mesenchymoma of the retropharyngeal space
H K Leong1, C Y Kwan, R E Stanley
1Department of Otolaryngology, National University Hospital, Singapore.
Abstract:
Malignant mesenchymoma is a very rare head and neck tumour. To date only 15 cases have been reported in world literature and all in children under 16 years of age. We present here a case of a 40-year-old man with malignant mesenchymoma of the retropharyngeal space. The clinical picture is that of progressive dysphagia, voice change, snoring and dyspnoea. CT scan showed a soft tissue space-occupying lesion of the retropharyngeal space which enhanced very well with intravenous contrast. The tumour was excised in toto and the patient given post-operative radiotherapy. Histopathology showed two unrelated differentiated tissue types (bone and fat) in addition to the fibrosarcomatous element thus satisfying Stout's criteria (Stout, 1948) for a diagnosis of malignant mesenchymoma.
Insights
Malignant mesenchymoma, a rare head and neck tumor, is typically seen in children. This case report details a rare adult presentation of this rare tumor in the retropharyngeal space.
Area of Science:
- Oncology
- Pathology
Background:
- Malignant mesenchymoma is an exceptionally rare tumor, with only 15 pediatric cases reported globally.
- This diagnosis is characterized by the presence of at least two unrelated differentiated tissue types alongside a fibrosarcomatous component.
Observation:
- A 40-year-old male presented with progressive dysphagia, voice changes, snoring, and dyspnea.
- CT imaging revealed a contrast-enhancing soft tissue mass in the retropharyngeal space.
Findings:
- Surgical excision of the retropharyngeal mass was performed, followed by adjuvant radiotherapy.
- Histopathological examination confirmed malignant mesenchymoma, identifying bone and fat tissues within the fibrosarcomatous stroma, meeting Stout's diagnostic criteria.
Implications:
- This case expands the known age range for malignant mesenchymoma, highlighting its potential occurrence in adults.
- The successful management underscores the importance of surgical resection and radiotherapy in treating this rare head and neck malignancy.