1/8. Endoscopically assisted anterior cranial skull base resection of sinonasal tumors.The traditional approach to sinonasal tumors involving the base of skull has been the anterior craniofacial resection. Endoscopic techniques have created the potential to approach the intranasal aspect of skull base lesions without external incisions and still develop an en bloc resection when removed. We report our initial experience with skull base neoplasms in which the otolaryngic portion of the standard resection was accomplished instead through an endoscopic approach. The nature of lesions favorable for this approach and associated technical issues are discussed. Although we do not consider this approach a replacement for the traditional anterior craniofacial resection, it is an important adjunct in the skull base surgeon's armamentarium.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/8. Sinonasal ossifying fibroma with fluid-fluid levels on MR images.Ossifying fibroma is a rare benign neoplasm that usually affects mandibular and maxillary bones. In this report, we present a case of sinonasal ossifying fibroma with fluid-fluid levels and posterior extension toward the torus tubarius on MR images.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/8. Respiratory epithelial adenomatoid hamartoma associated with nasal polyposis.hamartoma is a rare, non-neoplastic tumor characterized by an abnormal mixture of tissues, which are indigenous to the region. They are rare in the nasal cavity. We report a 79-year-old woman with an adenomatoid hamartoma in the left nasal cavity associated with nasal polyposis. This association supports the hypothesis that inflammation is one of the factors that induce the development of a hamartoma. Functional endoscopic sinus surgery was performed to completely remove it, and this lesion was found to have arisen from the lateral nasal wall. It is an unusual localization because the most common site in the nasal cavity is the nasal septum, particularly the posterior aspect. Limited but complete surgical resection is the treatment of choice. Although adenomatoid hamartoma arising from the sinonasal tract is very rare, head and neck surgeons should be aware of this pathological entity as a differential diagnosis for inverted papilloma and adenocarcinoma. Misinterpretation of these lesions as a true neoplasm may result in unnecessarily aggressive surgery for this benign lesion.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
4/8. Schneiderian papilloma of the nose and paranasal sinuses: the University of Ottawa experience.Schneiderian papillomata of the nose and the paranasal sinuses are uncommon neoplasms. Although histologically benign, malignancy can occur. The likely etiologic agent is the human papilloma virus. We reviewed the cases treated at University of Ottawa-affiliated hospitals from 1969-1989. There were 35 patients consisting of 26 men and nine women with an average age of 55.8 years. The most common presenting symptom was unilateral nasal obstruction (71.4%). This was caused in most cases by an ipsilateral polypoid mass (82.9%). CT scan study was helpful in delineating the size and extent of the lesion. Four cases of malignancy were found (11.4%). Whether malignant transformation had occurred or whether a synchronous or metachronous malignancy had been serendipitously discovered is open to debate. Thorough examination with biopsy is mandatory to obtain a definitive histologic diagnosis. Intranasal papilloma-plucking (polypectomy) is useful for biopsy purposes but grossly inadequate as definitive treatment. The high recurrence rate is due to inadequate resection. Radical surgery consisting of medial maxillectomy via the lateral rhinotomy approach has the lowest recurrence rate (7.1%) and is the treatment of choice.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
5/8. Unusual anatomic presentations of inverting papilloma.Due to their tendency to recur, and a potential for malignancy, inverting papillomas of the nasal cavity and paranasal sinuses pose a challenge to the head and neck surgeon. Although the majority of these benign neoplasms arise from the lateral nasal wall, middle meatus, and ethmoid complex, they occasionally originate from atypical areas in which Schneiderian membrane is present. Four unusual anatomical presentations of inverting papilloma are presented and discussed.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
6/8. Nasal masses in infants and children.Nasal or perinasal masses in children may be classified as congenital or developmental masses, inflammatory lesions, or benign or malignant neoplasms. Because of a possible connection with the central nervous system, nasal masses may be difficult to manage. A premature biopsy, or even a noninvasive palpation, may precipitate intracranial infection, meningitis, or severe bleeding. The indolent nature and benign appearance of these lesions shold not lead to deferral of complete evaluation and appropriate treatment.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
7/8. Benign nasal polyps causing bone destruction in the nasal cavity and paranasal sinuses.Benign nasal polyposis, when extensive, can cause bone displacement and destruction within the nasal cavity and paranasal sinuses. Consequently it may be difficult to distinguish this entity from a malignant neoplasm.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
8/8. Pituitary adenoma presenting as sinonasal tumor: pitfalls in diagnosis.Pituitary adenomas may cause significant difficulties in histological diagnosis when presenting in unusual sites either as extension from an intrasellar lesion or as ectopic tumor. Three such cases, involving the sinonasal tract are described herein, and the differential diagnoses are discussed. Two of them were invasive intrasellar macroadenomas that presented as unilateral nasal polyp, and one was an ectopic pituitary adenoma involving the sphenoid sinus. There was notable cellular atypia in two cases, with nuclear pleomorphism, giant cells, chromatin clumping, and distinct nucleoli, leading to serious consideration of the possibility of poorly differentiated carcinoma. In none of the cases was the diagnosis of pituitary adenoma suspected clinically. The clues to diagnosis were an endocrine growth pattern comprising tumor cells arranged in packets, ribbons, or rosettes, with prominent delicate vascularized stroma; a high index of suspicion; and immunohistochemical showing of neuroendocrine markers and pituitary hormones in the tumor cells. A correct diagnosis is important because in contrast to neuroendocrine carcinoma as a whole or to poorly differentiated carcinoma, pituitary neoplasms have a much more favorable prognosis and a low metastatic potential.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |