鼻腔神经纤维瘤2例报道及文献复习

目的探讨单发于鼻腔的神经纤维瘤的临床特点,以提高诊断及治疗水平。方法回顾性分析2例单发于鼻腔的神经纤维瘤的临床资料并复习相关文献。结果2例患者均因鼻塞就诊,鼻内镜下完整切除肿瘤;术后随访症状缓解,未见肿瘤复发。结论单发于鼻腔的神经纤维瘤少见,免疫组化为确诊手段,首选鼻内镜下手术治疗效果好。     

Inflammatory myofibroblastic tumor of the nasal cavity: a case report and review of the literature

Our aim is to describe clinicopathological, histochemical, and immunohistochemical findings of one case of inflammatory myofibroblastic tumor of the nasal cavity. A 10-year-old female presented with a short history of nasal obstruction, epistaxis, nasal discharge and headache. Computerized tomography (CT) scans showed a space-occupying lesion in the right nasal cavity. Histological examination of initial biopsy showed fascicles of spindle cells in a mixed inflammatory background with a predominance of plasma cells, typical of inflammatory pseudotumor. The spindle cells were positive for vimentin and actin. The mass was completely excised without any difficulty under generalized anesthesia. Inflammatory myofibroblastic tumor of the nasal cavity is a localized and completely benign lesion. Simple complete excision is curative.     

The monthly interesting case -- case no. 64. Cavernous hemangioma

An 89 year old female patient presented with severe epistaxis and nasal congestion on the right side. On endoscopic examination of the nasal cavity a reddish-bluish tumor has been seen that almost completely filled the posterior part of the cavity. In the MRI a highly vasculated tumor was shown. Performing transnasal endoscopic surgery the tumor was completely removed from the nasal cavity. On histopathologic examination the tumor turned out to be a cavernous haemangioma affecting the posterior end of the right turbinate. Cavernous haemangiomas in this region are very rare.     

Basaloid Squamous Cell Carcinoma in Nasal Cavity

Basaloid squamous cell carcinoma (BSCC) is often founded in the head and neck region. However, BSCC in the sinonasal tract is rare. We report here on the case of a 58-yr-old woman who presented with nasal obstruction and epistaxis. Computed tomography and examination of the nasal cavity revealed a tumor mass that originated from the right inferior turbinate with erosion of the nasal floor. The tumor that was attached to the inferior turbinate, the lateral nasal wall and the eroded right side hard palate, and so all this was resected. Histopathologic examination of the excised tumor confirmed BSCC in the nasal cavity. We report here on a nasal cavity BSCC that was treated with partial maxillectomy only.     

导管超声在鼻腔鼻窦占位性病变中的应用价值

目的探索导管超声探头在鼻腔、鼻窦占位性病变中的应用价值。方法鼻腔、鼻窦占位性病变患者18例，其中良性肿物12例，恶性肿瘤6例。应用Siemens Squia 512超声仪，电视鼻内镜引导导管超声探头经鼻腔扫查鼻腔内肿物。灰阶超声观察病变区的大小、形态、边界、回声及其与周围组织的关系；彩色多普勒观察病变的血流分布，频谱多普勒进一步分析血流的性质和速度。结果内镜引导下用导管超声探头可准确地扫查鼻腔内肿物。灰阶超声检查显示肿物多呈不均质低回声，富含血管的肿瘤回声更低，部分瘤内可探及粗大血管所形成的不规则透声区。神经纤维瘤边界清楚、规则，有较完整的包膜；脊索瘤边界欠清，无明显包膜。1例破坏蝶窦骨质突人鼻腔的垂体瘤，超声可清楚地显示肿块与颈内动脉的关系。彩色多普勒能显示肿物内血供是否丰富，频谱多普勒可区分动脉或静脉血流信号，并测量流速。血管纤维瘤内血供丰富，而恶性肿瘤一般血流丰富，流速较高。结论鼻内镜引导下的鼻腔软组织占位病变超声检查定位准确，图像清晰，分辨率高，能敏感地显示肿物的血供并区分动、静脉血流。丰富了鼻腔、鼻窦占位性病变的影像检查方法。     

A case of myoepithelioma of the nasal cavity

Myoepithelioma is a rare tumor, most frequently located in the salivary gland. Case reports of extra-salivary myoepithelioma are sporadic, with only one case in the nasal cavity. A 68-year-old male patient presented with a myoepithelioma of the nasal cavity manifesting as nasal obstruction and epistaxis, which was treated successfully with endoscopic excision. Histological examination revealed myoepithelial cells and myxoid stroma, which confirmed the diagnosis of myoepithelioma. The behavioral pattern is similar to if not identical with that of the mixed tumor, pleomorphic adenoma, which is benign, but the potential for recurrence is always present, especially if complete resection is not achieved.     

Nasal cavity paraganglioma with malignant transformation: a case report

BACKGROUND: In this report, we describe a young woman with a nasal cavity paraganglioma with malignant transformation. METHODS AND RESULTS: A 23-year-old woman presented with frequent right-sided epistaxis. Physical examination revealed a pedunculated mass originating from the right superior turbinate and filling the posterior nasal cavity. The endoscopically removed mass was composed of a reddish anterior portion and a white, flesh-looking posterior portion, the latter comprising the majority of the tumor. Histologically, the anterior portion showed a paraganglioma and the posterior portion showed a separate malignant lesion simulating Ewing's sarcoma/PNET. She underwent wide endoscopic excision including the site of tumor origin and has been followed up for 3 years without any evidence of disease recurrence. CONCLUSION: This is a rare case of nasal cavity paraganglioma that had transformed into a malignant tumor.     

Neurinom der Nasenhaupthöhle

A 35 years old male patient presented with serous nasal secretion, relapsing epistaxis and a slowly progredient nasal obstruction. Clinical examination and CT scans showed a tumor occupying the left middle meatus and the whole nasal cavity displosing the nasal septum to the right side. The tumor was resected by a midfacial degloving approach. Histological examination showed a neurinoma. By means of the presented case report and a review of literature, diagnosis and treatment of this rare nasal tumor are discussed.     

The rare case of nasal glioma

The authors presented a case of nasal glioma in an adult man which had performed as nasal polyp. Histopathologic studies confirmed neuroglial tissue--Astrocytoma fibrillare. These tumor cells were immunohistochemically positive for glial fibrillary acidic protein as well as for S-100 protein and vimentin. There was no communication between the tumor and the cranial cavity on radiological examination (TC, MRI). Treatment is usually surgical. In this article authors describe a case of a nasal glioma that was removed via a lateral rhinotomy.     

现代放疗技术下鼻腔鼻窦恶性肿瘤转归分析

目的:评价基于现代放疗技术条件下鼻腔鼻窦恶性肿瘤的生物学行为差异及其治疗和疗效.方法:回顾性分析2004-2007年间治疗的200例鼻腔鼻窦恶性肿瘤患者病例资料.全部病例采用CT模拟定位及三维适形放疗技术.结果:在鼻腔鼻窦各种恶性肿瘤中,以发病部位计,发生率鼻腔＞上颌窦＞筛窦＞蝶窦.从病理学角度分析,以鳞状细胞癌发病率...     

Sinonasal glomangiopericytoma--case report

Haemangiopericytoma is a rare vascular tumor originated from perivascular cells. A sinonasal-type of haemangiopericytoma is called glomangiopericytoma. This type of hemangiopericytoma is usually of low malignant potential. The most common symptoms are nasal breathing disturbances and epistaxis. The clinical diagnosis may be difficult. The radiological imaging techniques (CT) can provide adequate information with regard to extension of the tumor, although final histological confirmation is essential. Surgery is the treatment of choice. We present a case of 45-year-old male patient complaining of epistaxis and left side nasal obstruction. Radiological examination (CT) showed the tumor localized in the left nasal cavity extending to the left maxillary sinus and ethmoidal cells. The tumor was removed via lateral rhinotomy with complete amelioration of symptoms. The tumor was diagnosed as glomangiopericytoma by histologic and immunohistochemical findings. During the 16-months follow-up no recurrence or epistaxis was observed.     

Glomangiopericytoma of the nasal cavity

Glomangiopericytoma is a rare tumor arising from the pericytes surrounding capillaries, and accounts for less than 0.5% of all sinonasal tumors. A 60-year-old male patient presented with a glomangiopericytoma of the nasal cavity manifesting as nasal obstruction and epistaxis, which was treated successfully with endoscopic excision. Histological examination showed multiplication of spindle-shaped to oval cells which reacted strongly to immunostaining for α-smooth muscle actin. Glomangiopericytoma is categorized as a borderline low malignancy tumor, which tends to recurrence. Strict follow-up is required, especially if complete resection is not achieved.     

鼻腔鼻窦腺样囊性癌放疗后诱发未分化多形性肉瘤1例报道

目的 总结鼻腔鼻窦腺样囊性癌放疗后诱发未分化多形性肉瘤(UPS)的诊疗经验.方法 回顾性分析1例鼻腔鼻窦腺样囊性癌术后4年放疗诱发未分化多形性肉瘤患者的临床资料,并结合文献进行分析.结果 患者于2015年1月行鼻侧切开上颌骨大部分切除术,术中完整切除肿瘤,术后病检结果提示为左侧上颌窦腺样囊性癌,术后规律行放化疗,201...     

Primary Kaposi’s sarcoma of the nasal cavity not associated with AIDS

Kaposi’s sarcoma (KS) is an unusual vascular tumor characterized by multiple reddish blue nodules, which usually present on the skin of the lower and upper extremities. KS may also involve mucosal sites, lymph nodes and visceral organs. During the last two decades, with the large increase in the incidence of this tumor associated with the acquired immune deficiency syndrome (AIDS), there have been increasing number of cases with KS presenting on the skin or mucosa of the head and neck. A review of the literature revealed that only six cases of primary KS of the nasal cavity have previously been published and only one of them presented in a patient not associated with AIDS. We report the case of a 59-year-old woman who presented 4 years ago with nasal obstruction and intermittent minor epistaxes. Physical examination revealed the presence of a fleshy tumor arising from the left nasal septum, which was excised. Histological examination of the tumor showed morphological and immunohistochemical features of KS. A complete physical and laboratory examination revealed no other pathological findings. The patient received no further treatment and 4 years later, she is in excellent condition. In the present study, we report the second case where the primary manifestation of the KS was in the nasal cavity in a patient with an adequate immune system.     

Solitärer fibröser Tumor der Nasenhaupt- und Nasennebenhöhlen

Objective

The solitary fibrous tumor is an uncommon, benign lesion with a mesenchymal origin which arises most commonly from the pleura and, in extremely rare cases, from the mucosa of the nose and paranasal sinuses.

Patient and methods

We describe a case of solitary fibrous tumor in the nasal cavity with an extension into both ethmoid sinuses and destruction of the nasal septum in a 64-year-old woman presenting with nasal obstruction and frontal headache. In the histopathologic examination and by immunohistochemistry, the tumor was composed of spindle cells and nodular collagen, and was confirmed as a solitary fibrous tumor. It was completely removed using an endonasal approach with the patient being free of any complaints and without evidence of disease 2 years after surgery.

Conclusions

Solitary fibrous tumor should be included in diagnostic considerations in patients with sinonasal masses, especially in cases with the appearance of spindle cells. Diagnostic procedures, clinicopathological features, therapeutic options and prognosis of the such tumors are discussed.     

A case report of FSH-producing nasal ectopic pituitary adenoma extending to the frontal cranial fossa

We report the first case of an ectopic pituitary adenoma in the nasal cavity that produced follicle-stimulating hormone (FSH). A 60-year-old man complaining of left nasal bleeding had a polypoid tumor in the left nasal cavity. Findings of computed tomographic scanning and magnetic resonance imaging showed that the tumor originated from the olfactory cleft, occupied the nasal cavity, and extended to the frontal cranial fossa. Results of histologic examination suggested ectopic pituitary adenoma. Magnetic resonance imaging results showed the pituitary gland to be normal. Electron microscopy findings demonstrated a large number of secretory granules in the tumor cells that were positive for FSH on immunohistochemical analyses. Serum gonadotropin levels were normal, and no clinical signs of hypersecretory syndrome were noted. The above findings led us to establish the diagnosis of FSH-producing ectopic pituitary adenoma. The patient underwent craniofacial resection of the tumor followed by an uneventful recovery. The pathologic findings and clinical course of the case were comparable to those of FSH-producing adenomas arising from the pituitary gland.     

Epithelial-myoepithelial carcinoma of the maxillary sinus: a rare case

Epithelial-myoepithelial carcinoma (EMC) is a rare tumor that commonly involves the salivary glands. EMC of the maxillary sinus is extremely rare. We describe here a case of a 50-year-old patient who presented with right cheek swelling for 7 years and bilateral nasal obstruction and right nasal bleeding for 3 months. A pinkish polypoidal mass was seen in the right nasal cavity. Computed tomography scan revealed an expansile soft tissue mass in the right maxillary sinus with erosion of all of its walls. Histopathological examination of the excised specimen confirmed myoepithelial carcinoma with positive reaction to S-100 and smooth muscle actin. Subsequently, the patient developed regional nodal metastasis in the neck for which neck dissection was performed. Histopathology of the neck dissection specimen revealed metastatic EMC. EMC is rare tumor and a diagnostic dilemma. It should be considered in cases showing dual tumor cell population with clear cell change in histopathology. Common differential diagnosis includes metastatic renal cell carcinoma, acinic cell carcinoma, adenoid cystic carcinoma, mucoepidermoid carcinoma, oncocytoma, and sebaceous carcinoma. Laryngoscope, 2012.     

Hemangioma of the nasal cavity: a clinicopathologic study

Objective: The purpose of this study was determining the optimal surgical approach and preoperative examination for a hemangioma of the nasal cavity. We performed to summarize the indications of endoscopic surgery and its postoperative course. Methods: Eight patients with a history of epistaxis found to have an intranasal hemangioma were studied. Radiological study, postoperative course examination after the endoscopic surgery, and histological study were performed on these cases. Results: Preoperative computed tomography (CT) scan and MR image together with postoperative histological studies demonstrated characteristic figures of epithelioid hemangioma. Radiological studies were necessary to examine the extension of the tumor. The capillary type usually arose from the nasal septum while the cavernous type was seen in the lateral nasal wall. The postoperative course of the patient was uneventful, and no recurrence was found after endoscopic surgery in all cases. Conclusion: Radiological study was proven effective for the pre-surgical diagnosis. The hemangioma strictly pertaining to the nasal cavity can be completely treated by the endoscopic transnasal surgery. We suggest that the method inflict least stress on the patient and thus considered optimal.     

A double-blind randomised controlled trial assessing the efficacy of topical lidocaine in extended flexible endoscopic nasal examinations

Clin. Otolaryngol. 2011, 36 , 550–557 Objective: To test the hypothesis that using lidocaine nasal spray will result in improved pain and comfort outcomes during an extended flexible endoscopic nasal examination. Design: A split‐body, double‐blind, placebo‐controlled randomised trial. After receiving a rinse of oral mouthwash (Listerine^®), patients were randomised to receive placebo in one nasal cavity and 30 mg of topical lidocaine in the other. Setting: A tertiary care centre outpatient Otolaryngology clinic. Participants: Twenty‐two patients who required an extended bilateral flexible endoscopic nasal examination. An extended nasal examination consisted of an examination of a minimum of two osteomeatal regions on each side of the nasal cavity. Main outcome measures: Discomfort and pain were assessed using a 100‐mm Visual Analogue Scale (VAS). Our study utilised the definition of pain based on International Association for the Study of Pain. Pain was defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Discomfort was defined as the overall unpleasant experience of the procedure. This included all aspects of the examination such as the pain or other negative sensations associated with the examination, any side effects associated with the application of the nasal sprays as well as any anxiety associated with the examination. A Wilcoxon sign‐rank test was used for the primary outcome measures. Results: There was a significant reduction in discomfort scores on the treatment side of the nasal cavity compared with the control side (median VAS score of 18.6 mm versus 44.6 mm; P = 0.01). The change in pain between the treatment side compared with the control side did not reach our definition of statistical significance (5.1 mm versus 9.2 mm; P = 0.05). Patients with an active or uncontrolled inflammatory disorder of the nasal cavity experienced a significantly greater reduction in pain compared to those without an inflammatory condition (median change of the VAS score, ?15.6 versus +1.0; P = 0.01). Conclusions: After a rinse with oral mouthwash, the use of lidocaine results in a significant reduction in the discomfort associated with an extended bilateral flexible endoscopic nasal examination. Patients undergoing such an examination would benefit from the application of lidocaine after masking the negative flavour using oral mouthwash.     

鼻腔鼻窦孤立性纤维性肿瘤1例报道及文献复习

目的 探讨发生于鼻腔鼻窦的孤立性纤维性肿瘤(SFT)的临床诊治经验.方法 结合1例鼻腔及鼻窦SFT患者的病例资料,并回顾性分析国内外文献,对SFT的临床特点、诊断与治疗进行讨论.本例患者术前CT提示:左侧鼻腔鼻窦肿物性质不明,鼻腔息肉可能.予以鼻腔新生物活检后鼻腔出血量大,随即全麻下行鼻内镜左侧鼻腔鼻窦新生物切除术,并...