Thyroid-like low grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare malignant tumor that originates in the nasopharynx. Pathologically, the tumor shows papillary thyroid cancer-like findings of a thyroid transcription factor-1 (TTF-1)-positive and thyroglobulin (TG)-negative status. We report a case of nasopharyngeal papillary adenocarcinoma at the posterior end of the nasal septum.
A 50-year-old woman presented with sore throat in our department. Nasal endoscopy revealed a pedunculated tumor at the posterior end of the nasal septum. CT and MRI showed a pedunculated tumor without cervical lymph node swelling. Biopsy revealed a TL-LGNPPA that was TTF-1-positive and TG-negative. The tumor was endoscopically resected under general anesthesia without any complications. The pathological margin was negative. No recurrence or metastasis has been observed in one year and 6 months after the operation.
"},{"@language":"ja","@value":"Thyroid-like low grade nasopharyngeal papillary adenocarcinoma（TL-LGNPPA）は甲状腺乳頭癌様の病理所見を示し，免疫染色でTTF-1陽性，TG陰性となる特徴を持つ上咽頭や鼻中隔後端に発生する珍しい悪性腫瘍である。今回われわれは鼻中隔後端に発生したNasopharyngeal papillary adenocarcinoma（NPPA）の一例を経験したので文献的考察を加え報告する。
症例は50歳女性で，咽頭違和感を主訴に前医を受診した際，鼻中隔後端に腫瘤を指摘され当科紹介となった。経鼻内視鏡検査で鼻中隔後端に有茎性の腫瘤を認め，造影CTでは鼻中隔後端に6 mm大の有茎性腫瘤，造影MRIでは病変部はT1，T2ともに正常粘膜と同程度の信号である腫瘍が確認できた。腫瘍生検を施行したところ，TL-LGNPPAの所見でTTF-1陽性，TG陰性であった。全身麻酔下に内視鏡を用いて鼻中隔後端の腫瘤を完全摘出した。手術標本の病理所見では断端陰性であり，追加治療は行わなかった。また明らかな術後合併症は認めず，術後1年6ヶ月経過したが明らかな再発や転移の所見は認めていない。
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