1/56. 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 = 1keywords = mucosa (Clic here for more details about this article) |
2/56. Sinonasal mucosa-associated lymphoid tissue lymphoma.Mucosa-associated lymphoid tissue (MALT) is a specialized form of lymphoid tissue that may be acquired at sites in response to chronic inflammation. Most low-grade, B-cell, non-Hodgkin lymphomas that occur at extranodal sites derive from acquired MALT. Confusing and overlapping terms have been used to describe these lymphomas, but immunohistochemical advances now allow more precise subtyping. Our review of the literature yielded only 2 previous reports of sinonasal MALT-derived lymphoma, and we report an additional case in a patient with a history of chronic sinusitis. Current developmental theories of MALT-derived lymphomas are discussed. In addition, we review the clinical, histologic, and immunophenotypic features of MALT-derived lymphomas.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
3/56. A giant intracranial mucocele associated with an orbitoethmoidal osteoma. Case report.The authors present a rare case of a giant intracranial mucocele associated with an orbitoethmoidal osteoma in a patient suffering from a generalized convulsive disorder. The broad pedicle of the osteoma had penetrated the cribriform plate and extended intracranially to form a nodular mass in the olfactory groove. The intracranial portion of the osteoma was surrounded by a mucocele. Both the cyst wall and multilayered intracystic septations of the mucocele were indented by layers of the osteoma. Although the extracranial portion adhered to the mucosa of the ethmoidal sinus, there were no signs of sinus obstruction. No direct communication other than the osteoma was identified between the mucocele and the ethmoidal mucosa. The large cerebral defect, which the mucocele occupied, communicated directly with the lateral ventricle without any intervening membranous structures. A frontal craniotomy is recommended for exposure of the lesion and plastic repair of the dural defect.- - - - - - - - - - ranking = 0.5keywords = mucosa (Clic here for more details about this article) |
4/56. Sinonasal teratocarcinosarcoma: ultrastructural and immunohistochemical evidence of neuroectodermal origin.The authors report a case of sinonasal teratocarcinosarcoma in a 37-year-old man, which was located in the anterior skull base and extended to the right nasal cavity and paranasal sinuses. The tumor was surgically resected twice, but it could not be removed completely. Microscopically, it was mainly composed of primitive cell nests within a moderately cellular stroma. The components of squamous cell epithelia with focal teratoid appearance and adenocarcinomatous differentiation were observed. There were many rhabdomyoblasts scattered in the nests and stroma. Ultrastructurally, the primitive cells had many neural processes with parallel microtubules, resembling olfactory neuroblastoma. Rhabdomyoblasts showed various degrees of skeletal muscle differentiation. Some of the stromal spindle cells had actin filaments with dense patches and dense core granules. Immunohistochemically, the primitive cells were positive for epithelial markers, neuron-specific enolase, synaptophysin, and myogenic regulatory proteins. The rhabdomyoblasts showed immunoreactivity for myoid markers, cytokeratin, epithelial membrane antigen, and synaptophysin. Most of the stromal spindle cells were positive for smooth muscle actin, neuron-specific enolase and synaptophysin. The immunohistochemical and ultrastructural findings suggest that primitive cells had the most primitive phenotype of placodes, and support the possibility that sinonasal teratocarcinosarcoma is essentially a neuroectodermal tumor with divergent differentiation.- - - - - - - - - - ranking = 0.0057068885722704keywords = membrane (Clic here for more details about this article) |
5/56. Endoscopic and electroporation therapy of paranasal sinus tumors.The purpose of this article is to introduce the concept of endoscopic and electroporation therapy for the treatment of sinonasal carcinomas. electroporation therapy is a technique that combines intralesional injection of bleomycin combined with application of high-voltage square wave electrical impulse into the tumor. A transient increase in cell membrane permeability allows intracellular entry of bleomycin, with subsequent cytotoxicity. Two cases of sinonasal cancer were treated with this technique. One patient had complete response and is free of disease at 20 months. The other had partial response with control of the disease up to a year. Endoscopic electroporation therapy is potentially a minimally invasive method for the treatment of sinonasal malignancies in an experimental setting where other treatment options do not exist. Phase II/III national clinical trials have been initiated to study the efficacy of electroporation therapy.- - - - - - - - - - ranking = 0.0057068885722704keywords = membrane (Clic here for more details about this article) |
6/56. Radiographic features of olfactory neuroblastoma.Olfactory neuroblastomas are malignant, slowly growing neurogenic tumors originating from the olfactory mucosa of the nasal cavity. Fourteen patients with this tumor were evaluated and showed variable extension into adjacent structures such as the ethmoid and sphenoid sinuses, orbit, and anterior cranial cavity.- - - - - - - - - - ranking = 0.25keywords = mucosa (Clic here for more details about this article) |
7/56. Sinonasal mucosal malignant melanoma: report of an unusual case mimicking schwannoma.Primary mucosal melanoma of the sinonasal tract is a rare malignancy that has a more aggressive clinical course than its cutaneous counterpart. The histology of these lesions varies, with differing degrees of melanin production and an epithelioid or spindle-cell growth pattern. Cutaneous melanocytic lesions may differentiate in accordance with their neural crest derivation and express morphology similar to nerve sheath tumors. We believe the following case study reports the first instance of a mucosal melanoma with a Schwannian pattern of growth, arising from the nasal cavity of a 26-year-old man.- - - - - - - - - - ranking = 1.5keywords = mucosa (Clic here for more details about this article) |
8/56. Neurilemmomas of the paranasal sinuses.Within the head and neck region, neurilemmomas are rarely found in the nasal cavity or paranasal sinuses. A 70-year-old man presented with complaints of left-sided epiphora, rhinorrhea, epistaxis, and transient diplopia. Nasal endoscopy showed a large necrotic mass filling the left middle meatus. A computed tomography scan showed a large left ethmoid mass, with erosion of the medial wall of the orbit and the anterior cranial base. Multiple biopsies were nondiagnostic. Complete excision of the tumor was performed with endoscopic techniques. Small dural defects were repaired with a middle turbinate mucosal flap. Postoperatively, the patient was treated with nasal packing and a lumbar spinal drain. Final pathology showed a benign neurilemmoma. There has been no evidence of recurrence or cerebrospinal fluid leakage in follow-up. A review of the literature shows a similar presentation of patients with neurilemmomas of the paranasal sinuses. Bony destruction and intracranial extension is viewed. Lack of encapsulation and locally destructive growth in an otherwise histologically typical neurilemmoma should not suggest malignant potential. Many benign tumors of the paranasal sinuses with bone destruction may be removed by using endoscopic techniques.- - - - - - - - - - ranking = 0.25keywords = mucosa (Clic here for more details about this article) |
9/56. Sinonasal undifferentiated carcinoma with orbital invasion: report of three cases.PURPOSE: To report three patients with sinonasal undifferentiated carcinoma (SNUC) that invaded the orbit. methods: Retrospective small case series. The clinical, radiographic, and pathologic features of three patients with SNUC were reviewed. RESULTS: Three patients with SNUC that invaded the orbit were evaluated. A biopsy was performed on the tumors, which were composed of small, hyperchromatic cells with numerous mitoses and areas of necrosis. Immunohistochemical staining was positive for cytokeratins AE1.3, epithelial membrane antigen, and neuron-specific enolase in all three tumors. Electron microscopic examination showed absence of neurosecretory granules and presence of basement membrane production. Two patients were treated with surgical resection and postoperative chemotherapy and/or radiation. One patient was treated with preoperative radiation and chemotherapy. CONCLUSIONS: Sinonasal undifferentiated carcinoma is a high-grade tumor that arises in the nasal and paranasal sinuses and may invade the orbit. SNUC should be distinguished from other small, round, blue cell tumors, in particular, esthesioneuroblastoma.- - - - - - - - - - ranking = 0.011413777144541keywords = membrane (Clic here for more details about this article) |
10/56. Massive osteolysis of skull bones secondary to lymphangioma of paranasal sinuses and mastoid sinus: report of two cases in children.Massive osteolysis (MO) is a rare condition in which progressive localized bone tissue resorption is associated with proliferating thin-walled vessels in the absence of inflammation. Rare cases have been reported to occur in the skull. This paper describes two patients with MO who presented with massive assymetric swelling of the skull. This was associated with extensive enlargement of the paranasal sinuses (frontal, ethmoidal, and sphenoidal in one and the mastoid air cells in the other). The second patient developed subcutaneous emphysema on several occasions and the valsalva maneuver increased the swelling, indicating transmission of the air from the nasopharynx to the mastoid cells and from there to the subcutaneous tissue. In the first patient, the sinus mucosa was shown to be involved by an extensive lymphangioma, and a similar change was seen in the mastoid air cells (patient 2). We are proposing that MO of these two patients resulted from bone resorption due to progressive extension of sinus mucous lymphangiomata.- - - - - - - - - - ranking = 0.25keywords = mucosa (Clic here for more details about this article) |
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