Clin Exp Otorhinolaryngol.  2013 Jun;6(2):107-109.

Sclerosing Polycystic Adenosis of the Nasal Septum: The Risk of Misdiagnosis

• Park IH
• Hong SM
• Choi H
• Chang H
• Lee HM

Abstract

Sclerosing polycyctic adenosis (SPA) is a rare lesion of unknown etiology morphologically resembling fibrocystic changes of the breast. To date, approximately 41 cases of SPA have been reported. Most cases of SPA have originated in the parotid and submandibular glands, with a few cases of intra-oral minor salivary gland origin. This is the first reported case of sclerosing polycystic adenosis of nasal minor salivary gland origin. The differential diagnosis of SPA includes polycystic disease, sclerosing sialadenitis, and benign and malignant glandular neoplasias. Although atypia ranging from mild dysplasia to carcinoma in situ can occur in some cases, SPA has a favorable outcome. It is important to be familiar with SPA to avoid aggresive treatment that results from a misdiagnosis. We present a case of a 49-year-old man who had 1-year history of right nasal obstruction.

Keyword

Minor salivary gland; Nasal septum; Tumor

MeSH Terms

Breast
Carcinoma in Situ
Diagnosis, Differential
Diagnostic Errors
Nasal Obstruction
Nasal Septum
Salivary Glands, Minor
Sialadenitis
Submandibular Gland

Figure

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  Fig. 1 Nasal endoscopic finding showing a pedunculated, red, friable mass with an irregular surface arising from the right nasal septum (arrow).

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  Fig. 2 Computed tomogram axial view showing polypoidal mass attached to the posterior part of the right nasal septum without any erosions of the surrounding structures (arrow).

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  Fig. 3 Microscopic examination reveals lobular proliferation of dilated ductal components with cystic changes surrounded by abundant dense, hyalinized, hypocellular, collagen stroma (H&E, ×40). Inset: The dilated ducts are lined with flatted cuboidal cells with foci of apocrine metaplasia (arrow; H&E, ×400).

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  Fig. 4 (A) Immunohistochemical staining for smooth muscle actin demonstrated myoepithelial cells surrounding ductal epithelium (H&E, ×100). (B) Focal ductal epithelial cells showed immunoreactivity for estrogen receptor (H&E, ×400).

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