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Case Reports
. 2016 Nov 22:2016:bcr2016217386.
doi: 10.1136/bcr-2016-217386.

Smooth muscle tumour of uncertain malignant potential (SMTUMP) in the nasal cavity: an incidental finding

Dipak Ranjan Nayak  1 , Asheesh Dora Ghanpur  2 , Apoorva N Reddy  3 , Swati Sharma  4
Affiliations
Case Reports

Smooth muscle tumour of uncertain malignant potential (SMTUMP) in the nasal cavity: an incidental finding

Dipak Ranjan Nayak et al. BMJ Case Rep. .

Abstract

Sino-nasal smooth muscle tumours of uncertain malignant potential (SMTUMP) are very rare neoplasms of mesenchymal origin with features in between a benign leiomyoma and a leiomyosarcoma. We report a rare case of SMTUMP in a 44-year-old woman, who presented with vague symptoms of pharyngitis. Nasal endoscopy revealed a smooth mass in left nasal cavity. Contrast-enhanced CT and MRI scans showed features likely to be inverted papilloma or olfactory neuroblastoma or meningioma. Excision was planned and intraoperatively, frozen section revealed a probable spindle cell lesion. Final histopathological report following immunohistochemistry (IHC) & immunofluoresence (IF) confirmed it to be a SMTUMP. This patient underwent complete resection via endoscopic KTP laser assisted, anterior skull base surgery with no recurrence on follow-up.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Diagnostic nasal endoscopy showing mass in superior part of left nasal cavity.
Figure 2
Figure 2
Coronal section of contrast-enhanced CT—paranasal sinus (PNS) showing the lesion.
Figure 3
Figure 3
Iso to hyperintense on T2 weighted MRI and fluid-attenuated inversion recovery (FLAIR) imaging.
Figure 4
Figure 4
Debulking with microdebrider.
Figure 5
Figure 5
Mucosal incision using KTP 532 laser.
Figure 6
Figure 6
Septal flap to cover dura and olfactory nerve endings.
Figure 7
Figure 7
Nasal epithelium overlying a non-encapsulated tumour haematoxilin & eosin (H&E) (×20).
Figure 8
Figure 8
Fascicles of spindle-shaped cells with slender vesicular nuclei and scanty to moderate cytoplasm H&E (×100).
Figure 9
Figure 9
Immunohistochemistry showing that the tissue was positive for SMA (×100). SMA, smooth muscle antigen.
Figure 10
Figure 10
Immunohistochemistry showing the tissue was negative for CK (×100). CK, cytokeratin.
Figure 11
Figure 11
Ki-67 proliferative index was <5% (×100).
See this image and copyright information in PMC

References

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