Human papillomavirus-related multiphenotypic sinonasal carcinoma

Human papillomavirus-related multiphenotypic sinonasal carcinoma (HMSC) is a rare primary tumor of the sinonasal tract that has been reported recently. It is reportedly associated with human papillomavirus infection. The tumor presents with glandular cyst-like histology, but some cases exhibit squamous epithelialization and are positive on p16 immunohistochemical staining. The clinical picture and treatment of this disease have not been established. However, this report describes a recurrent case of this disease treated with salvage surgery. The patient was a 61-year-old woman who presented to the previous doctor with a chief complaint of nasal obstruction. A localized tumor was found in the left nasal cavity and was resected under endoscopic guidance. The postoperative pathological diagnosis was HMSC. Twenty-one months after the surgery, local recurrence was observed, and the patient was referred to our hospital. Since the recurrent lesion had widely infiltrated outside the nasal cavity, extensive resection and reconstructive surgery were performed. Postoperative radiotherapy was performed as an additional treatment. Notably, 13 months have passed since the salvage surgery, and no recurrence has been observed to date.     

Blue nevi of the sinonasal mucosa: a report of two cases and review of the literature

Blue nevi are uncommon melanocytic proliferations. They occur mostly in the skin and occasionally in mucosae. Blue nevi of the sinonasal mucosa are extremely rare with only two cases reported to date. We report two more cases and review the literature. Compared with sinonasal malignant melanomas, which usually present as symptomatic tumors, sinonasal blue nevi are asymptomatic lesions found incidentally. A biopsy is required for a definitive diagnosis. Although none of the four cases had recurrence, given a rare but possible occurrence of malignant transformation in cutaneous blue nevi, complete excision with follow up should be the treatment of choice.     

Leiomyosarcoma of the sinonasal tract: a case report and literature review

Leiomyosarcoma of the paranasal sinuses is uncommon and has an aggressive clinical behavior. Only 28 cases have been described in the literature, and, of these, only 3 patients treated with surgery had a disease-free survival. In this report, we describe the clinical history of a 57-year-old woman with a leiomyosarcoma of the paranasal sinuses successfully treated with a combination of surgery, radiation therapy, and chemotherapy. We obtained a total response with ifosfamide, doxorubicin, dacarbazine, and epirubicin. This case report emphasizes the possibility of treating this aggressive tumor with chemotherapy in accordance with the same therapy used in the treatment of uterine leiomyosarcomas.     

Multifocal,recurrent sinonasal leiomyosarcoma: case report and review of literature

Leiomyosarcoma is a rare tumor encountered in the sinus and skull base, and can be difficult to control. We present a case of an 83 year old female with a recurrent sinonasal leiomyosarcoma. The tumor exhibited variable growth rates of recurrences in non-contiguous sites despite having obtained clear surgical margins and use of adjuvant therapy. This case illustrates unusual characteristics of this rare tumor that are important for clinicians to know. Patient demographics, presenting symptoms, risk factors, treatment options, and prognosis are also reviewed.     

内窥镜手术治疗鼻腔-鼻窦恶性肿瘤:病例报告及文献复习

目的探讨内窥镜手术切除鼻腔及鼻窦恶性肿瘤的适应证、可行性及治疗效果.方法鼻内窥镜下切除鼻腔-鼻窦恶性肿瘤4例,其中低分化鳞癌1例、黏液表皮样癌1例、非霍奇金淋巴瘤(T细胞型)1例、乳头状瘤恶变1例.其中2例行术后放疗,1例行术后化疗,1例未行放疗及化疗.结果术后随访2.5～ 7年,平均4.3年,患者均健在.其中1例生存5年,因术后3年局部复发,再次行内窥镜手术.结论经选择的鼻腔及鼻窦早期原发性或复发性恶性肿瘤,可经内窥镜手术彻底切除,术后配合放疗或化疗,可取得满意的治疗效果,其优点是损伤小、恢复快、无面部瘢痕,易被患者接受.     

Pediatric invasive sinonasal Scopulariopsis brevicaulis--a case report and literature review

Objective

Acute invasive fungal sinusitis (AIFS) appears mainly in immunocompromized patients and may be caused by various pathogens. We describe a teenager with invasive sinonasal Scopulariopsis brevicaulis and review all the reports on this rare pathogen.

Methods

A literature search on Scopulariopsis sinonasal invasive infections was performed and clinical data including age, gender, co-morbidities, treatment and prognosis was collected on all the patients.

Results

A 17 years old boy with acute myelocytic leukemia and Scopulariopsis brevicaulis sinonasal infection was successfully treated at our department with a combination of extensive surgical debridement and antifungal antibiotics. We found six articled describing six patients with AIFS due to Scopulariopsis species. Four patients were adults and two were children, 3 males and 3 females. Two had an infection with Scopulariopsis acremoium, one with Scopulariopsis candida and for 3 patients no data was given on the specific Scopulariopsis species. All the patients except one were immunocompromized. One patient was treated with antifungal drugs, 2 with surgery and 4 patients received antifungals and were operated. One patient died due to the fungal infection and two patients died due to other causes.

Conclusions

Scopulariopsis AIFS is a life threatening disease affecting mainly immunocompromized patients, both children and adults. No clear treatment regimen has been established yet. We describe the first case of a teenager with Scopulariopsis brevicaulis sinonasal infection treated successfully with a combination of wide local excision and antifungal therapy.     

Combined-modality treatment improved outcome in sinonasal undifferentiated carcinoma: single-institutional experience of 21 patients and review of the literature

The optimal treatment of sinonasal undifferentiated carcinoma (SNUC) remains unclear. We report our results on the outcome and toxicity of patients with SNUC treated by a combined modality and attempt to define the optimal treatment strategies by reviewing the literature. Between 1996 and 2010, 21 consecutive patients with SNUC were treated by any combination of surgery, chemotherapy and radiotherapy. End points were local control (LC), regional control (RC), disease-free (DFS), cause-specific (CSS) overall survival (OS), and late toxicity. Organ preservation was defined as visual preservation without orbital exenteration. After median follow-up of 54 months, the 5-year actuarial rates of LC, RC, DFS, CSS, and OS were 80, 90, 64, 74, and 74 % respectively. On multivariate analysis, T-stage and multimodality treatment approach correlated significantly with LC. Elective nodal irradiation was given to 42 % of high-risk node-negative patients. None of them developed regional failure. The overall 5-year incidence of grade ≥2 late toxicity was 30 %. Treatment-related blindness was significantly decreased in patients treated with intensity-modulated radiotherapy (IMRT), compared to 2D and 3D-conformal radiotherapy (3DCRT), with organ preservation rates of 86 and 14 % respectively (p = 0.006). We concluded that combined-modality treatment with three, or at least two, modalities resulted in good LC, but with high overall rate of late toxicity. However, the incidence of late toxicity and permanent visual impairment were decreased over time by the introduction of IMRT. Because of the improvement in therapeutic ratio achieved by using IMRT, this highly conformal radiation technique should be the standard of care in patients with SNUC.     

Parathyroid carcinoma: a report of two cases and a concise review and update of the literature

Parathyroid carcinoma is very rare and when diagnosed can be difficult to treat as more than 50 per cent have persistent or recurrent disease. Patients generally present with profound symptoms of hypercalcaemia and a palpable neck mass. We describe a case of parathyroid carcinoma in primary hyperparathyroidism and a case in tertiary hyperparathyroidism in a renal dialysis patient. Most studies in the literature are retrospective but recent trends in presentation, treatment options and complications have been reviewed and are summarized in this paper.     

颈部转移性Merkel细胞癌1例并文献复习

目的 探讨Merkel细胞癌的临床表现及诊疗方法。方法 回顾性分析1例颈部转移性Merkel细胞癌患者的临床资料并复习相关文献进行总结。结果 对患者采取术中肿物扩大切除+淋巴结清扫+患侧锁骨上动脉岛状瓣移植。术后随访1年患者恢复良好,未见局部复发及远处转移征象。结论 Merkel细胞癌具有局部复发率、淋巴结转移率高的特点,目前肿瘤切除仍是Merkel细胞癌治疗的一线选择,依据肿瘤侵袭范围选择个体化的治疗方案尤为关键。     

喉神经内分泌癌2例报告附文献复习

目的探讨喉神经内分泌癌的临床表现,并对其诊断及治疗进行探讨。方法对2例喉神经内分泌癌临床表现、病理、诊断、治疗和预后进行回顾性分析。结果 2例肿瘤均位于声门上区,直径<2 cm,病变局限,非浸润性生长,与周围组织边界清晰。术前依靠病理确诊,采取喉部分切除,1例随访6年,未见复发及转移;另1例仍在随访中。结论喉神经内分泌癌是一种较为罕见的恶性肿瘤,正确诊断有赖于临床症状、体征、组织病理学及免疫组织化学检查。熟悉其临床特征,对术前正确诊断、术中术式的选择及术后放疗、化疗的配合应用和提高患者术后生存率有重要意义。     

Pediatric sinonasal rhabdomyosarcoma: three cases and a review of the literature

OBJECTIVE: To understand the clinical presentation, management, and natural history of paranasal rhabdomyosarcoma. DESIGN: Retrospective case series review. METHODS: Retrospective medical record review of patients less than 20 years of age who presented to our facility with rhabdomyosarcoma of the nasal cavity or paranasal sinuses. RESULTS: Medical records of all pediatric patients seen in our pediatric otolaryngology clinic were reviewed from January 1, 1995, through December 31, 2000. Three patients were identified with sinonasal rhabdomyosarcoma. Their presentation, evaluation, and treatment were evaluated. Relevant literature 1966 to the present was reviewed with the assistance of Medline. CONCLUSIONS: Rhabdomyosarcoma is an aggressive pediatric malignancy, requiring a high index of suspicion to detect it in its earliest stages. Patients with suggestive symptoms should undergo a full evaluation including nasal endoscopy and imaging. Because the current chemotherapy protocols are more effective on localized disease, early diagnosis is crucial to patient survival.     

婴儿鼻腔软骨间叶性错构瘤2例及文献复习

目的 探讨婴儿鼻腔软骨间叶性错构瘤的临床及病理特点、诊断、治疗及预后。 方法 回顾性分析2016年5月至2019年3月上海交通大学医学院附属新华医院收治的2例经病理证实为鼻腔软骨间叶性错构瘤患儿的临床及病理资料,并对该病的诊断、治疗及预后进行探讨。 结果 起源于鼻腔或颅底的鼻腔软骨间叶性错构瘤经鼻内镜术完整切除,长期随访无复发。组织学显示间叶细胞及胶原纤维围绕软骨结构,呈良性增生特性。 结论 婴儿鼻腔软骨间叶性错构瘤临床表现多样且无特异性,早期诊断困难。鼻内镜手术是治疗鼻腔软骨间叶性错构瘤的主要手段,并且具有良好的临床效果。     

鳃裂癌一例报告并文献复习

正鳃裂癌是原发于鳃裂残迹的恶性肿瘤,以鳞状上皮癌为主要病理类型。发病率很低,目前文献报道多为个案。现结合广东省中医院大学城医院耳鼻喉科收治1例鳃裂癌患者的病历资料,并复习相关文献,总结鳃裂癌的诊断要点,重点讨论鳃裂癌的治疗方法,报道如下。1资料与方法.1一般资料患者男,61岁,2014年10月发现     

Small-cell laryngeal neuroendocrine carcinoma. A case report and review of literature

A case of small-cell carcinoma of larynx was diagnosed in a 48-year-old man. This is an unusual laryngeal carcinoma (the incidence is lower than 1% of all carcinomata in this location). We analyzed some clinical and histopathological aspects of these carcinomata and some prognostic and therapeutic factors. A bibliographic review was made.     

Sclerosing mucoepidermoid carcinoma of the salivary gland: Case report and literature review

Sclerosing mucoepidermoid carcinoma (SMEC) is an extremely rare variant of mucoepidermoid carcinoma with unique histologic features. To the best of our knowledge, only 14 cases of salivary gland SMEC have been previously reported in the English-language literature since it was discovered in 1987. We report a new case of salivary gland SMEC, and we review the literature. Because of SMEC's distinctive histologic features and rarity, its diagnosis can be difficult. Moreover, no clear treatment strategy has emerged with regard to adjuvant postoperative radiotherapy. We attempt to elucidate a natural course of this disease, and we propose a conservative approach to postoperative management.     

Hamartoma of the larynx: report of two cases and review of the literature

Hamartomas of the larynx are rare. Signs and symptoms vary but there is generally some degree of voice change and upper airway obstruction. The pathology may be misleading and can often be confused with other benign tumors of the larynx. Management should consist of conservative excision. Partial or total laryngectomy should be reserved for lesions involving too much of the laryngeal framework. Two cases of hamartomas of the larynx are reported requiring partial laryngectomy.     

Esthesioneuroblastoma: A case report and review of the literature

Esthesioneuroblastoma (ENB) is an extremely rare malignant neoplasm of the nasal cavity. We report the case of a middle aged man who presented with a 6-months history of progressive nasal obstruction, watering of the eye, headache and occasional epistaxis. A diagnosis of esthesioneuroblastoma was established by histopathology and confirmed by immunohistochemistry. On staging the mass was classified as a kadish stage C tumor. The mass was excised via a craniofacial resection through a bi-coronal approach and the tumor mass was peeled away completely from the frontal lobe dura. The patient underwent postoperative radiation, and he was free of recurrence at follow-up 3 months later.     

甲状舌管癌1例并文献复习

目的〓〖HTK〗探讨甲状舌管癌的诊断及治疗方法。〖HTW〗方法〓〖HTK〗回顾性分析1例甲状舌管癌患者病历资料,结合复习相关文献,对甲状舌管癌的起源、诊断及治疗方法进行讨论。〖HTW〗结果〓〖HTK〗甲状舌管癌多为乳头状癌,颈部CT有多囊结构、囊壁实性结节或钙化表现。〖HTW〗结论〓〖HTK〗甲状舌管癌临床罕见,囊肿迅速长大、颈部CT表现和细针穿刺是术前诊断的重要依据,Sistrunk术式是有效的原发灶切除方法。     

Primary mucinous eccrine carcinoma of the buccal space: A case report and review of the literature

Importance

Mucinous eccrine carcinoma is a rare entity that most commonly affects the head and neck. Due to its low frequency of occurrence, review of its etiology, histopathology, and treatment strategies is beneficial to all clinicians who may encounter similar appearing masses.