Metastatic carcinoma-ex pleomorphic adenoma of the pharynx with carotid space invasion: a rare case report

Abstract

Introduction: Carcinoma ex pleomorphic adenoma (CXPA) is a rare, aggressive malignancy of the salivary glands that arises from a pre-existing pleomorphic adenoma. Although pleomorphic adenomas are benign, their potential for malignant transformation necessitates timely diagnosis and management. Pathological assessment remains the gold standard for diagnosis, with surgery followed by radiotherapy being the standard of care.

Case Presentation: A 38-year-old male presented with a metastatic carcinoma ex pleomorphic adenoma of the pharynx, with invasion into the carotid space. Diagnosis was confirmed histopathologically. The patient underwent palliative radiotherapy.

Discussion: CXPA is often difficult to diagnose due to its overlapping features with benign tumors, especially in atypical locations such as the pharynx. Malignant transformation typically indicates a more aggressive clinical course, including local invasion and distant spread. In this case, carotid space involvement further complicated management, highlighting the importance of early detection and comprehensive treatment.

Conclusion: Early recognition of pleomorphic adenomas and their potential for malignant transformation is critical. This case emphasizes the need for a multidisciplinary approach in diagnosing and managing rare presentations of CXPA to improve patient outcomes.