An endonasal approach to the resection of a papillary seromucinous adenocarcinoma of the Eustacian tube

A review of the patient's chart and a review of the English literature were conducted.We describe the case of a 64 year-old woman who presented with a 3-year history of epistaxis and right-sided otitis media with effusion. The patient had been followed for a known nasopharyngeal mass that had twice been biopsied and in both cases was considered a benign mass pathologically. A third biopsy was diagnosed as a low-grade papillary seromucinous adenocarcinoma. The patient was otherwise asymptomatic. The patient was referred to a multidisciplinary cancer clinic at which endoscopic resection was determined to be the preferred treatment modality. A literature review and approach to patients with nasopharyngeal masses will be presented.Papillary seromucinous adenocarcinoma is a rare tumor that can present in the nasopharynx. We describe the endoscopic surgical management of one such patient that presented to our care.The nasopharynx accounts for less than 1% of malignancies in the United States. The most common malignancy in the nasopharynx is Nasopharyngeal Carcinoma (NPC), which is a form of squamous cell carcinoma (SCC) with a histopathology and behavior unique from SCC originating elsewhere in the head and neck [1]. However, the differential diagnosis for a nasopharyngeal mass remains broad. Benign lesions include but are not limited to juvenile nasal angiofibroma, thornwaldt’s cysts, papillomas, craniopharyngiomas and benign salivary gland tumors. In addition to NPC, chordomas, lymphoma, hemangiopericytoma, rhabdomyosarcroma and salivary gland tumors represent malignant lesions of the nasopharynx.A common problem with nasopharyngeal malignancies is that patients can often present without local symptoms; rather their primary tumor will be detected during the workup of a metastasis to a cervical lymph node [2]. Tumors of the nasopharynx can present with a common set of complaints, generally due to non-specific local effects of the neoplasm. Nasal obstruction may result fr