1/154. pneumocephalus associated with ethmoidal sinus osteoma--case report.A 35-year-old female suffered sudden onset of severe headache upon blowing her nose. No rhinorrhea or signs of meningeal irritation were noted. Computed tomography (CT) with bone windows clearly delineated a bony mass in the right ethmoid sinus, extending into the orbit and intracranially. Conventional CT demonstrated multiple air bubbles in the cisterns and around the mass in the right frontal skull base, suggesting that the mass was associated with entry of the air bubbles into the cranial cavity. T1- and T2-weighted magnetic resonance (MR) imaging showed a low-signal lesion that appeared to be an osteoma but did not show any air bubbles. Through a wide bilateral frontal craniotomy, the cauliflower-like osteoma was found to be protruding intracranially through the skull base and the overlying dura mater. The osteoma was removed, and the dural defect was covered with a fascia graft. Histological examination confirmed that the lesion was an osteoma. The operative procedure resolved the problem of air entry. CT is superior to MR imaging for diagnosing pneumocephalus, by providing a better assessment of bony destruction and better detection of small amounts of intracranial air.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/154. Primitive sinonasal malignant mucosal melanoma: description of a case treated with radiotherapy (0-7-21 regimen).Mucosal malignant melanoma (MMM) of the nasal cavity and paranasal sinuses is rare and has a poor prognosis. The rarity of MMM of the ethmoid is also noteworthy and primary treatment has been, till now, surgery and/or radiotherapy (RT). Here we report a case of MMM arising in the ethmoid of a caucasian man and treated with hypofractionated RT. A 32 year-old man presented with symptoms of cephalalgia, obstruction and nasal bleeding; a computed tomography (CT) showed a large mass that involved ethmoid, left orbit and roof of the nasal cavity. After biopsy, a MMM was found. Chest radiography demonstrated the presence of multiple lung metastases and still the patient was submitted to palliative radiotherapy according to 0-7-21 regimen with a total dose of 24Gy/3 fraction/21dd, dose per fraction 8Gy. The patient was asymptomatic one month after the end of RT and three months later a CT demonstrated a partial remission. The patient died 17 months after the initiation of RT for disseminated disease, without clinical signs of tumoral regrowth in the irradiated site. This case confirms the efficacy and the safety of 0-7-21 RT regimen; the absence of symptoms after 17 months and the poor prognosis encourage the use of RT as primary treatment for MMM of the head and neck.- - - - - - - - - - ranking = 2keywords = cavity (Clic here for more details about this article) |
3/154. Congenital nasal hemangiopericytoma: intrauterine, intraoperative, and histologic findings.hemangiopericytoma is a rare tumor of mesenchymal origin. To date, 91 cases of nasal or paranasal hemangiopericytoma and 59 congenital hemangiopericytomas have been reported in the literature. A congenital hemangiopericytoma arising from the nasal cavity and skull base has not yet been described. We report a case of a male newborn with a highly vascular nasal tumor diagnosed by in utero sonography with three-dimensional surface reconstruction. The tumor extended to the right anterior skull base, the right nasal cavity, and the right side of the nasal pyramid. A complete resection by neodymium:yttrium-aluminum-garnet-potassium titanyl phosphate ("Nd:YAG-KTP") laser was performed on the day of cesarean section at 33 weeks' gestation. The tumor was diagnosed as hemangiopericytoma by histologic and immunohistochemical findings. Postoperative nasal flow, feeding, and sight were unimpaired. At the 9-month follow-up, the infant remained free of disease.- - - - - - - - - - ranking = 2keywords = cavity (Clic here for more details about this article) |
4/154. Solitary fibrous tumor of the paranasal sinuses.Although solitary fibrous tumors are well-recognized in the pleura, their occurrence in the paranasal sinuses is decidedly uncommon. We have encountered two cases of solitary fibrous tumors in the paranasal sinuses and report the clinicopathological findings including CD34 immunoreactivity. One tumor arose in a 55-year-old Japanese businessman and the other in a 53-year-old man who had been in the hospital for schizophrenia for 20 years. The tumors showed characteristic findings. Immunoperoxidase stains on paraffin sections showed staining of the cells for anti-vimentin, but there was no staining for anti-keratin, anti-S-100 protein, anti-desmin, anti-glial fibrillary acidic protein (GFAP), or anti-actin. Anti-CD34 monoclonal antibodies also reacted with these tumors, as those of the pleura generally do, and were found to be useful in diagnosing these tumors. CD34 immunoreactivity [8]. Fukunaga et al. [6] reported that CD34 immunoreactivity presented in a solitary fibrous tumor of the nasal cavity, but separate tumors of the paranasal sinuses have not been analyzed. We have recently encountered two cases of solitary fibrous tumors of the paranasal sinuses. In this report, the clinicopathological features of these tumors of and their CD34 immunoreactivity were analyzed.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
5/154. Metastasis of a renal cell carcinoma to the nose and paranasal sinuses.We present a case of a metastasis of a renal cell carcinoma to the nose and paranasal sinuses. A 66 year old male patient developed a mass in his left nasal cavity and paranasal sinuses, five years after he underwent a left sided nefrectomy for a renal cell carcinoma. The histopathologic examination of the nasal mass showed metastasis of a renal cell carcinoma. A craniofacial resection was performed followed by radiotherapy.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
6/154. CT and MRI of congenital sinonasal ossifying fibroma.We report a 9-year-old boy with a sinonasal ossifying fibroma, probably congenital, with atypical findings on CT and MRI. CT revealed a soft-tissue density mass in the sphenoethmoidal sinuses, nasal cavity and right maxillary sinus with a few foci of calcification and with remodelling and destruction of the adjacent facial bones. MRI showed high signal on T2- and intermediate signal on T1-weighted images. A thin, partly enhancing outer shell and some nonenhancing septa were visible on contrast-enhanced images. MRI also showed the tumour to extend into the anterior cranial fossa. Subtotal removal was performed. We compare our findings with reports in the literature and discuss the differences from fibrous dysplasia.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
7/154. Extensive destruction of the eyeball by invasion of basal cell carcinoma of the eyelid.BACKGROUND: Eyeball destruction caused by invasion of basal cell carcinoma of the eyelid. CASE: A 100-year-old woman showed extensive eyeball destruction caused by the invasion of basal cell carcinoma of the eyelid. Complete ophthalmologic examinations, including computed tomographic (CT) scans of the orbit, were performed. The patient underwent incisional biopsy and bacteriological examination of the exudate from the lesion. OBSERVATIONS: Orbital CT scan showed a mass in the extraconal space of the right orbit, with extension to the adjacent sinus cavity without brain involvement. The remnant of the eyeball was posteriorly displaced. pseudomonas aeruginosa was identified by culture examination of the exudate. Histological study of the biopsy specimen showed basal cell carcinoma of the noduloulcerative type. CONCLUSIONS: Basal cell carcinoma of the eyelid had caused severe periorbital and eyeball destruction.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
8/154. Management of sinonasal hemangiopericytomas.The purpose of the present study is to report four cases of sinonasal hemangiopericytoma (HP) diagnosed and treated in our department between 1987 and 1998. The pretreatment findings and the treatment are described and discussed in the light of the literature. HP are unusual vascular tumors, featuring pericytes distributed around normal vascular channels. Two of these four cases were located in the nasal cavity and the other two were located in the maxillary sinus. Inside the nasal cavity, HP presented as a protruding reddish-gray mass with marked bleeding on contact. Electron microscopy and immunohistochemical techniques are essential for diagnosis and to distinguish HP from other sarcomatous tumors. Preoperative assessment included routine CT, MRI, arteriography and selective embolization. These tumors must be treated surgically with complete excision. An endonasal approach was performed in two cases of intranasal HP, while a combined external-endonasal approach was required for the other two cases of HP.- - - - - - - - - - ranking = 2keywords = cavity (Clic here for more details about this article) |
9/154. Sinonasal lymphomas. Case report.In the field of Otorhinolaryngology sinonasal lymphomas are relatively uncommon and represent less than 1% of all head and neck malignancies. Nowadays, they are regarded as consisting of two distinct subgroups, characterised by phenotype, location, prognosis and treatment. Lymphomas of the B-Cell phenotype are the most frequent type found in the paranasal sinuses. They are less aggressive and carry a relatively better prognosis. T/NK-Cell lymphomas are mostly found in the nasal cavity. They are more aggressive and carry a relatively worse prognosis. We present a case of a 65-year-old patient, who complained with unilateral right-sided nasal obstruction associated with a sensation of right aural fullness. CT scan demonstrated opacity of the posterior ethmoid and sphenoid sinuses on the right side, with evidence of erosion of the anterior wall of the sphenoid. Nasal endoscopy revealed a smooth purple mass, arising from the right superior meatus, which bled on contact, and which was subsequently shown to be, on histological assessment, a malignant high grade lymphoma, non-hodgkin's B-cell phenotype. Following a discussion of the case we will present a review of these tumours, which have a poor overall prognosis, focusing on epidemiology, sites of origin, symptoms, investigation and management.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
10/154. A case report of sinonasal teratocarcinosarcoma.A sinonasal teratocarcinosarcoma (SNTCS) is a rare and aggressive malignant neoplasm histologically characterized by the combination of one or more epithelial elements and mesenchymal components. We report a case of a 78-year-old man with SNTCS involving the nasal cavity and paranasal sinuses. He complained of epiphora and exophthalmos with weight loss. Physical and diagnostic images resulted T4N0M0. The tumor was completely and widely resected via a trans-facial approach to perform total maxillectomy with orbital exenteration. The clinical presentation, pathologic features, and clinical course are described with a review of the literature.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
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