TITLE Rare Case report of Pleomorphic Adenoma of the Nasal Cavity PRESENTING AUTHOR Dr Bhanu Pradeep AIM To report a rare case of recurrent pleomorphic adenoma of the nasal cavity with extensive local extension and to highlight the diagnostic and surgical challenges. METHODOLOGY A 51-year-old woman with no comorbidities presented with left-sided nasal obstruction from 5 years with multiple episodes of epistaxis with mild rhinorrhoea, postnasal dripping sensation and no other complaints. There was no history of visual defect, atopy or previous trauma to the nose. Her weight was stable and her general health was satisfactory with no palpable neck nodes. Examination revealed a large mass occupying the left nasal cavity and extending into the right nasal cavity through the septal defect, with nasopharyngeal stenosis. Contrast-enhanced CT showed a 6 × 5 × 4.1 cm lobulated lesion occupying the nasal cavity, extending into both choanae and the left maxillary sinus, with focal bony erosion and inferior orbital extension. under general anaesthesia in May 2025.She had undergone endoscopic left medial maxillectomy with partial septal resection and bilateral palatal flap reconstruction , with histopathology confirming pleomorphic adenoma. RESULTS Histopathology demonstrated cuboidal to polyhedral cells with mild nuclear pleomorphism, attempted glandular formation, perivascular arrangement and myxoid stromal change, consistent with pleomorphic adenoma. The lesion was excised endoscopically and patient is being followed up. CONCLUSIONS Pleomorphic adenoma of the nasal cavity is rare and may recur many years after surgery. Recurrent lesions can attain considerable size and extend across anatomical compartments, making management challenging. Detailed imaging, endoscopic assessment and histopathological evaluation are essential. Long-term surveillance is important because recurrence may occur after a prolonged disease-free interval.