Four cases of Pleomorphic Adenoma of the nasal cavity: An unusual entity

Pleomorphic adenomas are the most common benign tumor of the major salivary glands. In addition, they may also occur in the minor salivary glands of the hard and soft palate. Nasal masses are often due to antrochoanal or ethmoidal polyps or angiofibromas or haemangiomas or papillomas. Intranasal pleomorphic adenomas are very unusual and may be misdiagnosed because they have greater myoepithelial cellularity and fewer myxoid stromata compared to those elsewhere. Even though pleomorphic adenomas are seen rarely in nasal cavities, we have come across 4 cases in a period of 15 months. Here we present a case series of pleomorphic adenomas of the nasal cavity, out of which three presented as a huge nasal mass, one patient presenting with epistaxis as main symptom. All the nasal masses were unilateral, vascular and were arising from the nasal septum. They were seen to be occupying the nasal cavity, without causing any invasion of the lateral wall or the sinuses. One patient had pressure atrophy of the middle turbinate due the large nasal mass. In all patients the nasal mass was excised in toto, 3 patients through transnasal approach and 1 patient through through a lateral rhinotomy approach. All the patients were followed up regularly and no recurrence was noted in any of the cases. Histopathology revealed the nasal masses to be of mixed histology and pleomophic adenoma was considered.