A Rare Case of Epithelial Myoepithelial Carcinoma of the Nasaopharynx

Objectives: To present a very rare case of epithelialmyoepithelial carcinoma (EMC) of the nasopharynx and review the literature. Study design: Case presentation and review of the English literature. Methods: PubMed literature search Results: A 62-year-old female presented with 6-months history of right nasal obstruction and intermittent epistaxis. She was found to have a posterior nasopharyngeal mass that was biopsied twice before EMC could be diagnosed. She was then taken for endoscopic tumor debulking with adjuvant radiation therapy. Discussion: EMC is a rare salivary gland tumor usually affecting the parotid but can occur in minor salivary glands. Only 8 cases of EMC of the sinonasal tract have been reported. Presentation usually involves nasal obstruction and intermittent epistaxis. The typical appearance on exam is a smooth mucosal swelling. The mean age at presentation is the 5th decade with a female predominance, which is consistent with EMCs of the major salivary glands. Radiology usually shows a well-defined mass with variable bony erosion. Diagnosis depends on the surgical pathologist’s ability to identify epithelial ductal structures and myoepithelial cells. EMC is usually treated with wide local excision (WLE) however, in the nasopharynx, obtaining clear margins is difficult, thus treatment was augmented with adjuvant radiation. Conclusion: EMC is a very rare salivary gland tumor and even more rare in the sinonasal tract. While this tumor is usually treated with excision, in the nasopharynx, clear margins are difficult to achieve, thus, adjuvant radiation therapy should be considered. A Rare Case of Epithelial Myoepithelial Carcinoma of the Nasaopharynx