1/77. Aggressive giant pituitary adenoma presenting as a nasopharyngeal mass: magnetic resonance imaging and pathologic findings.We report a giant pituitary adenoma with aggressive histologic features that prominently invaded the nasopharynx. magnetic resonance imaging (MRI) demonstrated a large heterogeneous nodular mass that was hypointense to isointense on T1-weighted images and mixed hypointense, isointense, and hyperintense on T2-weighted images. The mass measured 7.5 x 5 x 7 cm, extending from the nasopharynx posteriorly through the clivus, and superiorly through the paranasal sinuses, and sellar-suprasellar region. After contrast administration, heterogeneous nodular enhancement was noted. A nasopharyngeal neoplasm extending into the sella was suspected because voice change and nasal speech long preceded the patient's visual symptoms. A biopsy disclosed an aggressive, infiltrating, hemorrhagic tumor, which was diagnosed as a non-secreting pituitary macroadenoma. This report indicates that pituitary adenomas may grow invasively to tremendously large sizes resulting in their initial presentation as nasopharyngeal masses.- - - - - - - - - - ranking = 1keywords = pituitary (Clic here for more details about this article) |
2/77. Melanin pigmented oncocytic metaplasia of the nasopharynx.A 64-year-old man presented with a history of discomfort of the throat of a few weeks' duration. Nasoscopic examination revealed multiple small, brown pigmentations at the left suprapharynx, the base of the left nasal cavity and the pharyngeal openings of the auditory tube on both sides. Microscopically, the lesion showed a glandular pattern of oncocytic epithelium with abundant pigmented granules and melanophages in the surrounding stroma. Immunohistochemically, the dendritic cells in the basal layer were positive for S-100 protein. Electron microscopic study revealed numerous fully melanized melanosomes and hypertrophied mitochondria in the oncocytic cells. Oncocytic cells do not produce melanin for themselves, melanin granules apparently being transferred from the adjacent dendritic cells to the oncocytic cells.- - - - - - - - - - ranking = 0.0060195073885174keywords = gland (Clic here for more details about this article) |
3/77. Epithelial-myoepithelial carcinoma arising in the nasal cavity: a case report and review of literature.Epithelial-myoepithelial carcinoma is an uncommon, low-grade, malignant epithelial neoplasm composed of variable proportions of ductular cells and large, clear staining, myoepithelial cells arranged around the periphery of the ducts. About 120 cases have been reported in the world literature, most of which were located in salivary glands, except for a few cases occurring in unusual locations such as breast, lacrimal gland, nose, paranasal sinus, trachea, bronchus, and lung. We here reported the second case of epithelial-myoepithelial carcinoma of the nasal cavity with extension to the nasopharynx. The patient was a 61 year old Chinese female with two month's history of progressive nasal obstruction. Histopathologically, the tumor showed typical myoepithelial and ductal cells biphasic differentiation, duct-like structure and infiltrating growth pattern. Some ductal cells showed the characteristics of oxyphilic cell, which had never been reported before. recurrence and metastasis rates of epithelial-myoepithelial carcinoma varied from 35% to 50% and 8.1% to 25% respectively in different reports. The present case had neither recurrence nor metastasis twenty months after operation. When epithelial-myoepithelial carcinoma is mainly composed of spindle myoepithelial cells, the differential diagnosis should include myoepithelioma, neurofibroma, leiomyoma and hemangiopericytoma.- - - - - - - - - - ranking = 0.012039014777035keywords = gland (Clic here for more details about this article) |
4/77. Polymorphous low-grade adenocarcinoma of the nasopharynx. Case report and review of the literature.BACKGROUND: The polymorphous low-grade adenocarcinoma of the nasopharynx is a rare disease. Polymorphous low-grade adenocarcinoma is a minor salivary gland neoplasm which occurs frequently in the mucosa of the soft and hard palates, in the buccal mucosa and in the upper lip. To date this entity has been identified within the oral cavity and only one case within the nasopharynx and some cases in the parotid gland. It has a slow infiltrating growing pattern with frequent perineural invasion and low metastatic potential. CASE REPORT: We report on a patient with non-papillary polymorphous low-grade adenocarcinoma in the nasopharynx which extended intracranially. The patient underwent primary radiotherapy. The CT showed partial response to radiotherapy and the patient is alive 51 months after the diagnosis his state being unchanged. CONCLUSION: The treatment for minor salivary gland tumor is primarily surgical. It is reported that the polymorphous low-grade adenocarcinoma has been known to have poor response to radiotherapy. However, we believe that in addition to its favorable biological behavior, the radiotherapy in this localization may result in longer survival.- - - - - - - - - - ranking = 0.018058522165552keywords = gland (Clic here for more details about this article) |
5/77. Pituitary adenomas with infra-sellar extension into the nasopharynx.Three cases of pituitary adenomas with infra-sellar extension into the nasopharynx and the nasal cavities are reported. The clinical signs were epistaxis, nasal obstruction, painful sinuses and purulent rhinorrhoea. The initial diagnostic hypothesis was that of a carcinoma of the nasopharynx or the sinuses in all three cases. The diagnosis was made by histological examination and measurement of plasma hormone levels. These cases highlight the difficulty in the diagnosis of such tumours due to their misleading clinical, radiological and histological features.- - - - - - - - - - ranking = 0.14285714285714keywords = pituitary (Clic here for more details about this article) |
6/77. brain abscess formation in radiation necrosis of the temporal lobe following radiation therapy for nasopharyngeal carcinoma.BACKGROUND: Radiation necrosis is a known complication following radiation therapy for extracranial as well as intracranial tumours. However, brain abscess formation in radiation necrosis has not been reported in the literature. We report the clinical data of 6 patients suffering from this condition. METHOD: Twenty-eight patients with radiation necrosis of the temporal lobe following radiotherapy for nasopharyngeal carcinoma were treated surgically at the Department of neurosurgery, Queen Elizabeth Hospital, hong kong between January 1992 and July 1999. Of these, 6 cases were complicated by brain abscess formation. The clinical data of these 6 patients are retrospectively reviewed. FINDINGS: The patients were 5 males and 1 female, ranging in age from 41 to 67 years. Three patients had previous treatment with steroids for the symptomatic radiation necrosis. A history of nasal infection or otitis media was recognised in all 6 patients. All patients were treated surgically by temporal lobectomy and excision of the necrotic tissue together with the abscess cavity. Intra-operatively, a bony defect was observed between the middle cranial fossa and the sphenoid sinus in 3 patients and the bony defect was repaired with a temporalis muscle flap. The species of organisms could only be identified in 3 patients. In 3 patients, the pus smear was positive but the culture was negative. Subsequently, 4 patients recovered and 2 patients died. INTERPRETATION: Cerebral radiation necrosis is a predisposing cause of brain abscess formation. Surgical excision is recommended as the treatment of choice in this group of patients.- - - - - - - - - - ranking = 0.0054675120111242keywords = lobe (Clic here for more details about this article) |
7/77. Epstein-Barr virus rna detection and glandular differentiation in nasopharyngeal carcinoma: report of 2 cases.Most tumors arising in the nasopharynx are either squamous cell carcinoma or so-called undifferentiated carcinoma of the nasopharyngeal type. Primary adenocarcinomas of the nasopharynx are rare, and glandular differentiation in undifferentiated carcinoma of the nasopharyngeal type has not been reported to date. We report 2 cases of undifferentiated carcinoma of the nasopharyngeal type that show distinct glandular differentiation by light microscopy, histochemistry, immunohistochemistry, and ultrastructure. Both tumors showed equal positivity for Epstein-Barr virus latent membrane protein and in situ hybridization for Epstein-Barr virus genome in the undifferentiated areas of the tumor and those featuring glandular differentiation.- - - - - - - - - - ranking = 0.042136551719622keywords = gland (Clic here for more details about this article) |
8/77. Acute hemorrhage in late radiation necrosis of the temporal lobe: report of five cases and review of the literature.hemorrhage in late cerebral radiation necrosis is a rare complication after radiotherapy for intracranial and extracranial neoplasms. We report 5 cases of acute hemorrhage in late radiation necrosis of the temporal lobe following radiation therapy for nasopharyngeal carcinoma. In a review of the literature, the authors identified a total of 27 such cases. The interval period between the onset of hemorrhage and cranial irradiation is long (mean = 7.8 years). The most prominent histological feature was the proliferation of large, dilated and thin-walled new blood vessels in a background of gliosis and fibrinoid necrosis of vessels. rupture of these thin-walled new blood vessels is the proposed mechanism of hemorrhage in this condition.- - - - - - - - - - ranking = 0.0045562600092701keywords = lobe (Clic here for more details about this article) |
9/77. Carcinoma ex pleomorphic adenoma of the palatal minor salivary gland with extension into the nasopharynx.Carcinoma ex pleomorphic adenoma presenting in the nasopharynx is extremely rare. We present a case of carcinoma ex pleomorphic adenoma occupying the nasopharynx and the soft palate in a 51-year-old woman. To the best of our knowledge, this is the first reported case of carcinoma ex pleomorphic adenoma in the nasopharynx.- - - - - - - - - - ranking = 0.02407802955407keywords = gland (Clic here for more details about this article) |
10/77. Upper respiratory tract carcinoma with chromosomal translocation 15;19: evidence for a distinct disease entity of young patients with a rapidly fatal course.BACKGROUND: Carcinoma of the upper respiratory tract is rare in childhood, and cytogenetic aberrations have not been characterized in this population. The chromosomal translocation 15;19 has been reported four times previously. All patients were young and had tumors arising in the thorax. The three reports that provide clinical follow-up all describe superior vena cava syndrome and death soon after presentation. All tumors were diagnosed as carcinoma (three undifferentiated, one mucoepidermoid), and the authors suggested thymus, lung, or germ cell origin. methods: The authors investigated the clinical and pathologic findings in two patients with poorly differentiated carcinoma showing evidence of t(15;19). This included a 13-year-old girl with a rapidly growing epiglottic mass, leading to superior vena cava syndrome and death and a 12-year-old girl with an aggressive nasopharyngeal mass showing intracranial extension. RESULTS: The laryngeal tumor was poorly differentiated, with vesicular nuclei, prominent nucleoli, extensive necrosis, and a lymphoplasmacytic infiltrate; cells were positive for cytokeratin and negative for lymphoma, melanoma, germ cell, and endocrine markers. Electron microscopy showed rare intermediate junctions and basal lamina. The nasopharyngeal tumor was poorly differentiated with areas of obvious squamous differentiation observed histologically, immunophenotypically, and ultrastructurally. Cytogenetic and fluorescent in situ hybridization studies were consistent with t(15;19)(q13;p13.1) in both cases. Both children received chemo- and radiotherapy. The first child died of disease after 36 weeks; autopsy revealed tumor in the larynx with spread to the skin/subcutis (neck and thorax) and lymph nodes (cervical, subcarinal, and pulmonary hilar). The second child developed widespread bony metastases and died of disease after 13 weeks. CONCLUSIONS: In conjunction with previous reports, the authors' findings show that t(15;19) is part of a distinct clinicopathologic entity characterized by young age, midline carcinoma of the neck or upper thorax, and a rapidly fatal course. female gender and superior vena cava syndrome are common. The histogenesis of these distinctive tumors is unknown. The authors' findings suggest origin in the upper airway, perhaps from submucosal glands.- - - - - - - - - - ranking = 0.0060195073885174keywords = gland (Clic here for more details about this article) |
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