Carcinoma ex pleomorphic adenoma of soft palate with cavernous sinus invasion.
BACKGROUND
Carcinoma ex pleomorphic adenoma (CXPA) is an aggressive salivary gland malignancy and rare in minor salivary gland. A soft palate CXPA initially presenting as direct cavernous sinus (CS) invasion is very rare.


METHODS
A 60-year-old male had a 3-month history of a small soft palatal mass with progressing left cheek numbness, proptosis, and disturbed vision. Biopsy of soft palatal tumor showed pleomorphic adenoma. Magnetic resonance imaging showed a tumor involving left maxilla, and extended from pterygopalatine fossa, inferior orbital fissure to CS. Excision of tumor revealed CXPA. Adjuvant concomitant chemo-radiation therapy (CCRT) was given. The tumor recurred 5 months later in left CS which was re-treated with CCRT. The disease status was stable at 2 years after the diagnosis of CXPA.


CONCLUSIONS
We present this case to emphasize that patients with symptoms such as facial numbness, proptosis and disturbed vision should be carefully investigated for lesions invading CS by perineural spread.
Chen
Hsuan-Ho
HH
Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taiwan.
Lee
Li-Yu
LY
Chin
Shy-Chyi
SC
Chen
I-How
IH
Liao
Chun-Ta
CT
Huang
Shiang-Fu
SF
D008949:Adenoma, Pleomorphic / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D002426:Cavernous Sinus / Q000473:pathology*; D003131:Combined Modality Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D010157:Palatal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D010160:Palate, Soft / Q000473:pathology*; D014057:Tomography, X-Ray Computed