Epithelial-myoepithelial carcinoma originating from a minor salivary gland in the nasal septum: A case report and literature review

Medicine (Baltimore). 2020 Jan;99(5):e19072. doi: 10.1097/MD.0000000000019072.

Abstract

Rationale: Epithelial-myoepithelial carcinoma is an extremely rare, malignant neoplasm that occurs most frequently in the major salivary glands and accounts for approximately 1% of all salivary gland neoplasms. Few reports have described the presence of epithelial-myoepithelial carcinoma in the sinonasal region; hence, the treatment guideline and prognosis remain unclear.

Patient concerns: We reported a case of a 75-year-old woman with complaint of nasal obstruction and frequent epistaxis for 3 years. During the nasal endoscopic examination, a mass in the left nasal cavity originating from the left nasal septum that caused bleeding on touch was observed.

Diagnoses: A diagnosis of epithelial-myoepithelial carcinoma was made based on the features of histopathology and immunohistochemistry of the surgical specimens. The patient was treated by surgical removal of the septal mass using the endonasal endoscopic approach.

Outcomes: In the serial follow-up paranasal sinus imaging and endoscopic inspection, evidence of recurrence was absent for 18 months after surgery.

Lessons: This report highlights a case of epithelial-myoepithelial carcinoma originating from a minor salivary gland in the nasal septum, one of the most unusual locations. Diagnosis of epithelial-myoepithelial carcinoma should be made based on the findings of immunohistochemistry of the operative specimen. Clinicians should consider complete surgical resection as the effective treatment of choice.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Carcinoma / pathology*
  • Carcinoma / surgery
  • Diagnosis, Differential
  • Female
  • Humans
  • Myoepithelioma / pathology*
  • Myoepithelioma / surgery
  • Nasal Septum / pathology*
  • Nasal Septum / surgery
  • Salivary Gland Neoplasms / pathology*
  • Salivary Gland Neoplasms / surgery
  • Salivary Glands, Minor / pathology*
  • Salivary Glands, Minor / surgery