Leiomyoma of the nasal cavity: case report and literature review

A 73-year-old man presented with a history of left nasal obstruction and mucosal discharge from the nose for several years. Nasal endoscopy showed a smooth red polyp in the left nasal cavity (Figure 1). A computed tomography scan showed the lesion was present in the left nasal cavity and the paranasal sinuses were clear (Figure 2). The polyp arose from the left sphenoethmoidal recess and was removed endoscopically. The patient has been followed up for 6 months with no evidence of recurrence. Macroscopically the tumour consisted of a polypoid mucosal-covered-mass measuring 4 x 2.5 x 1.5 cm. The consistency was firm and the cut surface was homogeneous grey-white. Microscopically the lesion comprised interweaving bundles of spindle-shaped cells with ovoid, nuclei, mild nuclear pleomorphism and eosinophilic cytoplasm (Figures 3 and 4). There was a variable amount of oedematous and fibrous stroma. There was no mitosis or necrosis. Immunocytochemical labelling showed patchy smooth muscle actin, mainly towards the periphery of the tumour and patchy central labelling for S-100 protein, but was negative for caldesmin, CD34, desmin, epithelioid membrane antigen and cytokeratin. The differential diagnosis included benign leiomyoma, benign nerve sheath tumour, solitary fibrous tumour and haemangiopericytoma. The lesion was considered to be a leiomyoma.