多形性腺瘤(PAs)是唾液腺的良性肿瘤。很少,它们出现在鼻窦腔,呈现为定义明确的,均匀的软组织肿块,引起膨胀的骨骼变化。PA的意义是可能引起恶性肿瘤-“多形性腺瘤”(CXPA)。这里,我们介绍了一个64岁的女性,抱怨进行性单侧充血和外部鼻子变形,主要是沿着基数的左轮廓,同侧眼的上泪点.最终,肿瘤开始从左鼻窦突出。计算机断层扫描排除了骨质溶解,而外科手术发现下鼻甲是肿瘤的起源。此外,发现同侧上颌窦发展为继发性鼻窦炎。在完成手术切除后,组织学结果是鼻窦黑色素瘤,但是在疾病没有进展之后,第二位病理学家具有额外的免疫组织化学标记(HMB-45(人类黑素瘤黑45)阴性,Melan-A(由T细胞1识别的黑色素瘤抗原)阴性,S100(中性pH下溶于100%硫酸铵的蛋白质)阳性,panCKAE1/AE3(泛细胞角蛋白抗体AE1和AE3)阴性,p63(肿瘤蛋白63)阴性,Ki-67(增殖标志物Kiel67)10%,CD68(分化簇68)阴性,CK7(细胞角蛋白7)阴性,和CDX2(尾型同源盒2)阴性)放置PA的明确诊断。下鼻甲的PA是极其罕见的发现,临床症状不明确。有时候,SOX-10(SRY-box转录因子10)阳性可导致恶性黑色素瘤,就像我们的情况一样,这就是为什么一组广泛的免疫组织化学标记对于明确诊断至关重要。
Pleomorphic adenomas (PAs) are benign tumors of the salivary glands. Rarely, they arise in the sinonasal cavity, presenting as well-defined, homogeneous soft tissue masses, causing expansive bony changes. The significance of PAs is the possibility of giving rise to malignant carcinoma - \"carcinoma ex-pleomorphic adenoma\" (CXPA).Here, we present the case of a 64-year-old female complaining of progressive unilateral congestion and external nose deformation, mostly along the left contour of the radix, with epiphora of the ipsilateral eye. Eventually, a tumor began protruding from the left naris. The computed tomography excluded osteolysis, while the surgical procedure discovered the inferior turbinate as the origin of the tumor. In addition, the ipsilateral maxillary sinus was found to have developed secondary sinusitis. After complete surgical excision, the histological result was sinonasal melanoma, but following no progression of the disease, a second pathologist with additional immunohistochemical markers (HMB-45 (human melanoma black 45) negative, Melan-A (melanoma antigen recognized by T-cells 1) negative, S100 (protein soluble in 100% ammonium sulfate at neutral pH) positive, panCK AE1/AE3 (pan cytokeratin antibodies AE1 and AE3) negative, p63 (tumor protein 63) negative, Ki-67 (marker of proliferation Kiel 67) 10%, CD68 (cluster of differentiation 68) negative, CK7 (cytokeratin 7) negative, and CDX2 (caudal-type homeobox 2) negative) placed the definitive diagnosis of PA.PA of the inferior turbinate is an extremely rare finding, with the clinical symptoms being unspecific. Sometimes, SOX-10 (SRY-box transcription factor 10) positivity can mislead to malignant melanoma, as in our case, which is why a broad panel of immunohistochemical markers is critical for the definitive diagnosis.