Malignant transformation of nasal chondromesenchymal hamartoma in adult: A case report and review of the literature

Yang Li, Qing-xu Yang, Xiao-ying Tian, Bin Li, Zhi Li*

*Corresponding author for this work

    Research output: Contribution to journalJournal articlepeer-review

    37 Citations (Scopus)

    Abstract

    Nasal chondromesenchymal hamartoma (NCMH) is an extremely rare benign tumor arising in the sinonasal tract, predominantly involving infants and children. To date, only 27 cases are reported in the international literature and there have been no reported cases of malignant transformation. We present a 40-yearold female patient with nasal obstruction and bloody rhinorrhea. Computed tomography (CT) of the nose and paranasal sinuses confirmed a heterogeneous polypoid soft-tissue mass filling the nasal cavity and extending into the maxillary and ethmoid sinus. The patient underwent a complete radical resection. Histological and immunohistochemical analyses showed a portion of the mass was consistent with typical NCMH. However, some areas of mass exhibited cytological atypia, marked mitotic activity and foci of necrosis. The atypical mesenchymal spindle cells were immunoreactive for vimentin, CD99 and smooth muscle actin (SMA) diffusely. The cartilaginous cells were immuno-positive for S-100 protein. Ki-67 index was high in atypical areas, accounting for 50%. A rapid mass recurrence was observed at the original site only 3 months after surgery. The final diagnosis of NCMH with malignant transformation was made. To our knowledge, this is the first report of malignant transformation occurring in an adult with NCMH. Although NCMH commonly develops in the neonate or young infants and exhibits benign histological appearance and favorable prognosis, there is a possibility of malignant transformation in adult patients. Thoroughly histological inspections are suggested to be necessary to accurately diagnose this tumor when it is encountered in adults.

    Original languageEnglish
    Pages (from-to)337-344
    Number of pages8
    JournalHistology and Histopathology
    Volume28
    Issue number3
    Publication statusPublished - Mar 2013

    Scopus Subject Areas

    • Pathology and Forensic Medicine
    • Histology

    User-Defined Keywords

    • Chondromesenchymal hamartoma
    • Malignant transformation
    • Nasal cavity
    • Adults
    • Differential diagnosis

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