Biphasic low-grade nasopharyngeal papillary adenocarcinoma: a case report and literature review.

BMC Clin Pathol

1Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611 Japan.

Published: October 2018

Background: Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is distinctly rare. We report a patient with a uniquely biphasic LGNPPA; additionally, we review similar tumors reported in the literature.

Case Presentation: A 56-year-old man presented with an asymptomatic pedunculated tumor in the vault of the nasopharynx, at the junction of the nasal septum and the roof, which was discovered during screening for laryngeal cancer. To obtain a definitive diagnosis, the patient underwent endoscopic endonasal surgery under general anesthesia. Immunohistochemical analysis of the tumor revealed it to be an LGNPPA with a prominent spindle cell component.

Conclusion: To our knowledge, this is the fourth reported LGNPPA exhibiting a spindle cell component and the second with a prominent pathological condition. The prognosis of LGNPPA is usually excellent. Therefore, it is important for clinicians to scrutinize the lesion's pathology to avoid unnecessary, disfiguring surgery.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172832PMC
http://dx.doi.org/10.1186/s12907-018-0076-1DOI Listing

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Article Synopsis
  • Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is a rare cancer affecting the nasopharynx, with a study involving 35 patients revealing common symptoms like nasal obstruction and rhinorrhea, primarily in individuals aged 11 to 71.
  • Most tumors were T1N0M0 stage and exhibited irregular papillary structures, with various histopathological features, such as squamous differentiation in some cases and a significant spindle cell component in many.
  • Treatment typically involves endoscopic surgical resection, and follow-up showed no recurrence or metastasis in patients, supporting the idea that LGNPPA may be better categorized as a primary papillary epithelial tumor due to its slow-growing nature.
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