Cases reported "Paranasal Sinus Neoplasms"

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11/117. 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.
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12/117. frontal sinus osteoma associated with cerebral abscess formation: a case report.

    BACKGROUND: Osteomas of the paranasal sinuses rarely lead to intracranial manifestations. We present an unusual case of a frontal sinus osteoma leading to intracerebral abscess formation. CASE DESCRIPTION: A 51-year-old Hispanic man presented with increasing frontal headaches, new onset seizure, lethargy, global dysphasia, and unilateral hemiparesis. CSF studies demonstrated mild pleocytosis. Neuroradiological studies revealed an opacity filling the left frontal sinus, as well as a ring-enhancing mass with surrounding edema in the left frontal lobe. The patient was surgically treated with a left frontal osteoplastic craniotomy and removal of the abscess and bony mass. Intraoperative cultures were positive for streptococcus pneumoniae. pathology revealed bony tumor consistent with osteoma. The patient's neurological status improved to baseline after surgery. CONCLUSION: The frontal sinus osteoma was associated with rapid development of a frontal lobe abscess, requiring emergent surgical debridement. Although rare, intracerebral manifestations should be considered and expected as a cause of new neurological deficits in the presence of paranasal sinus osteoma.
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13/117. Naso-ethmoid schwannoma with intracranial extension: case report.

    Intranasal schwannomas are rare lesions, specially when they present with an intracranial extension. The fifth case in the medical literature of a naso-ethmoid schwannoma with extension into the anterior cranial fossa is presented. The magnetic resonance findings and the details of the combined intracranial / transfacial operative approach used are described. The possible origin and the clinical characteristics of this rare lesion are reviewed.
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14/117. 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.
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15/117. leiomyosarcoma of the ethmoidal cells.

    Leiomyosarcomas of the paranasal sinuses are rare malignant tumors. A case of a 68-year-old female with leiomyosarcoma of the ethmoidal cells is presented. Since half a year she had a stuffed nose on both sides. Preoperatively, several attacks of epistaxis on the right side occurred. CT scans showed a tumor of the ethmoidal cells on the right side. The tumor was completely removed via a functional endoscopic endonasal approach and right sphenoethmoidectomy and maxillary sinus surgery. The operation was followed by a radiotherapy with 72 Gy. Up to 29 months after the operation local recurrence could not be observed. Endonasal tumor resection followed by radiotherapy in a case of leiomyosarcoma without invasion of orbit and skull base can allow tumor control.
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16/117. Sinonasal radiation-associated osteosarcoma after combined therapy for rhabdomyosarcoma of the nose.

    radiation-associated (RA) osteosarcomas (OS) are exceptional in children, presenting more frequently in middle-aged and elderly patients. This is a case report of RA-OS of the sinonasal cavities in a 13-yr-old girl after combined therapy for rhabdomyosarcoma (RMS) of the nose diagnosed at the age of five. The treatment of choice is radical surgery with wide margins and postoperative adjuvant chemotherapy and radiotherapy. Despite an episode of recurrence, at the present time the patient is alive and free of disease 5 yr after the initial treatment of OS. The association between radiation, chemotherapy and sarcomas is reviewed and discussed.
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17/117. Olfactory groove meningioma with paranasal sinus and nasal cavity extension: a combined approach.

    A 58-year-old man had an enlarging right fronto-orbital mass. A biopsy specimen of a right nasal cavity tumor was reported as meningioma. Preoperative evaluation including skull roentgenograms, tomograms of the paranasal sinuses, brain scan, computerized axial tomography, and carotid angiography substantiated a large subfrontal mass with paranasal sinus and orbital extension. A combined approach through a right frontal craniotomy and right lateral rhinotomy was used for a complete removal of this tumor. A review of the literature is contained herein.
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18/117. Fibrous xanthoma of the frontal sinus.

    frontal sinus mucocele was our preoperative diagnosis in a patient who had frontal swelling and downward displacement of the eye. Supporting this were typical roentgenogram changes, a long history of asthma, pansinusitis, and previous multiple-polypectomy surgery. frontal sinus exploration revealed a locally eroding lesion. It was composed of spindled cells and lipid-laden histiocytes with a pattern of fibrous xanthoma and was treated conservatively. It should not be confused with true malignancies such as fibrous histiocytoma having a similar histopathologic appearance and requiring more aggressive surgical treatment.
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19/117. craniopharyngioma involving supfrasellar region and sphenoid sinus: case report.

    Craniopharyngiomas are benign, epithelial, slow-growing neoplasms that generally develop either in the suprasellar region or in both the suprasellar and intrasellar regions. They rarely occurs in the infrasellar region. Based on embryologic development of adenohypophysis, the tumor can arise along the path of the craniopharyngeal duct. We report on an 8- year-old boy who presented to us with headache and anorexia for several weeks during May 1999. brain MRI revealed a huge sphenoid tumor. The tumor was completely excised by functional endoscopic sinus surgery on 12th August 1999. The postoperative course was smooth and no evidence of tumor recurrence was found on his latest follow-up visit in February, 2000. From the clinical experience with this case, functional endoscopic sinus surgery is an alternative and a less-harmful surgical procedure for this kind of benign sphenoid tumor. Moreover, embryology development, epidemiology, clinical presentation, diagnostic method and treatment of craniopharyngioma are discussed.
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20/117. Adenoid cystic carcinoma of the lacrimal gland with wide and severe myoepithelial differentiation.

    Adenoid cystic carcinoma (ACC) of the lacrimal gland is the second most common epithelial tumor for which different biologic courses can be predicted by histologic criteria. Three main types of growth patterns, cribriform; tubular; and solid have been identified. Tumors with solid components frequently follow a more aggressive clinical course and show worse prognosis than those with other patterns. We herein report a case of ACC with wide and severe myoepithelial differentiation arising from the lacrimal gland and presenting with aggressive clinical behavior. Postoperative radiotherapy may be the treatment of choice to control residual lesions and provide long-term survival even in the case of incomplete resection. Despite extensive surgery and radiation therapy, the prognosis of these tumors, especially with solid components, remains extremely poor. Accurate diagnosis is important because tumor histopathology is generally believed to be the most significant factor in patient survival.
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