Extramedullary plasmacytoma of paranasal sinuses. A combined therapeutic strategy.
(65/249)
Extramedullary plasmacytoma of the head and neck region is a rare malignant tumour comprising approximately 3% of all plasma cell tumours. Approximately 80-90% of extramedullary plasmacytomas involve the Mucosa-Associated Lymphoid Tissue of the upper airways, 75% of these involve the nasal and paranasal regions. Radiotherapy is considered the treatment of choice, surgery being limited to biopsy and to excision of residual disease. A case of extramedullary plasmacytoma of the nasal cavity and ethmoid sinus is reported, in which surgical excision is followed by complementary radiotherapy on the site of the tumour. (+info)
Oncocytic schneiderian papilloma found in a recurrent chronic paranasal sinusitis.
(66/249)
Oncocytic schneiderian papilloma (OSP), also known as cylindrical cell papilloma, is a rare benign sinonasal neoplasm. Due to its rare incidence, this disease is not well-understood by clinicians. The probability of malignancies arising in OSP is not low but they are rarely encountered in clinical practice. To the best of our knowledge, there is no documentation of OSP associated with recurrent chronic paranasal sinusitis (CPS). We hereby report an unusual case of OSP in a 28 year-old man which was first diagnosed and treated as recurrent chronic paranasal sinusitis. After three surgeries, OSP was revealed in the pathological findings and the tumor was completely resected endoscopically in the fourth operation. There was no sign of recurrence after two years of follow-up. A thorough review of histopathological slides from the first two surgeries showed no sign of OSP in these tissue sections. We present this case to remind clinicians that OSP can be found with inflammatory polyps in CPS, and it is easily overlooked clinically. Nevertheless, sufficient alertness from both the surgeon and pathologist is the cornerstone for the proper diagnosis and appropriate treatment of this rare nasal neoplasm. (+info)
Midfacial degloving--access to nasal cavity and paranasal sinuses lesions.
(67/249)
Common surgical approaches for medial maxillectomy include lateral rhinotomy and midfacial degloving. Lateral rhinotomy provides excellent surgical exposure but leaves a bulging scar on the face. Despite its own limitations, midfacial degloving has been preferred to lateral rhinotomy because it does not leave any external scar on the face(1). The aim of this study is to evaluate the cosmetic results and surgical exposure access of midfacial degloving. Treatment morbidity was evaluated through: post operative hospital stay length, blood transfusion needs, complications, pre and post operative hemoglobin levels, disease recurrence, nasal packing, type of suture and antibiotics. Retrospective study was carried out with sixteen patients treated at the Hospital Geral de Fortaleza SESA/SUS from December 1999 through November 2003. Based on the results, we may conclude that midfacial degloving is effective to treat extensive nasal cavity lesions and paranasal sinuses with reduced post operative morbidity. (+info)
Frontal sinus osteoma associated with pneumocephalus.
(68/249)
The most common causes of intracranial air are head trauma and neurosurgical procedures. Less common etiologies include infection due to gas-forming organisms, mucoceles, tumours, congenital neuroenteric cysts, and dural defects. Here, we present a case of a frontal sinus osteoma associated with longstanding pneumocephalus. (+info)
On the visualization of universal degeneracy in the IMRT problem.
(69/249)
BACKGROUND: In general, the IMRT optimisation problem possesses many equivalent solutions. This makes it difficult to decide whether a result produced by an IMRT planning algorithm can be further improved, e.g. by adding more beams, or whether it is close to the globally best solution. RESULTS: It is conjectured that the curvature properties of the objective function around any globally optimum dose distribution are universal. This allows an assessment of optimality of dose distributions that are generated by different beam arrangements in a complementary manner to the objective function value alone. A tool to visualize the curvature structure of the objective function is devised. CONCLUSION: In an example case, it is demonstrated how the assessment of the curvature space can indicate the equivalence of rival beam configurations and their proximity to the global optimum. (+info)
Intermittent respiratory obstruction secondary to a solitary fibrous tumour.
(70/249)
There have been fourteen cases of solitary fibrous tumour reported as originating from the paranasal sinuses. Here we report a case of solitary fibrous tumour that involved the right nasal cavity with extension into the oropharynx causing stertor and intermittent respiratory obtruction. Histopathology examination revealed the tumuor cells expressed CD34 turnout marker. (+info)
Intraosseous lipoma of the left frontoethmoidal sinuses and nasal cavity.
(71/249)
Intraosseous lipomas are very rare slow-growing benign tumors that may appear as congenital lesions or may be acquired (metaplasia from a pre-existing lipoma). Only a handful of head and neck cases have been reported in the literature. We present the first reported case of a solitary osteolipoma involving the sinonasal tract in a 66-year-old man with sinonasal symptoms. CT showed a lesion involving the left frontal sinus, extending into the ethmoid sinus with insinuation along the left middle turbinate. It appeared to be an atypical mass with areas of high attenuation (calcification) within. (+info)
Focal hyperostosis on CT of sinonasal inverted papilloma as a predictor of tumor origin.
(72/249)
BACKGROUND AND PURPOSE: To evaluate the CT characteristics of focal hyperostosis in patients with sinonasal inverted papilloma and to correlate these characteristics with the detection of the origins of tumors. MATERIALS AND METHODS: Paranasal sinus and nasal cavity CT images of 76 patients were reviewed retrospectively to detect areas within which there was focal hyperostosis. We correlated the sites on the CT scans within which there was focal hyperostosis with the origin of the tumors described in the corresponding patient's medical records. We also evaluated the CT features of focal hyperostosis according to the origin of tumors. RESULT: Surgical evaluation of 55 lesions with focal hyperostosis in CT images revealed that 49 of these lesions coincided with the actual origin of tumor. The CT-based determination of the locations of the areas of focal hyperostosis corresponded to the actual tumor origin in 89.1% of cases. Especially in cases with focal hyperostosis within the frontal, maxillary, sphenoid, and posterior ethmoid sinuses, areas of focal hyperostosis corresponded to the origin of tumor without exception. In the evaluation of the CT features of focal hyperostosis, 2 patterns of localized bone thickening were noted. Plaquelike bone thickening was seen mainly when focal hyperostosis involved the lateral wall of the nasal cavity. On the other hand, cone-shaped bone thickening was seen only in the walls of the paranasal sinuses or the bony septum. CONCLUSIONS: A high correlation between the origin of the inverted papilloma and focal hyperostosis on CT might facilitate preoperative prediction of tumor origin by radiologists and rhinologists. (+info)