NCI CANCERLIT^® Search: Paranasal Sinus and Nasal Cavity Cancer - September 2001

Last Modified: November 1, 2001

Risk of multiple primary cancers in nasal cancer patients.
A case of solitary nasal schwannoma.
[Frontal ethmoid metastases of prostatic carcinoma. Report of one case and review of the literature]
[Basocellular carcinoma and congenital angiomatosis]
Myofibrosarcoma of the nasal cavity and paranasal sinus.
Craniopharyngioma involving supfrasellar region and sphenoid sinus: case report.
Sinonasal angiosarcoma with marrow involvement at presentation mimicking malignant lymphoma: cytogenetic analysis using multiple techniques.
Inverting papilloma of the sphenoid sinus: report of two cases.
[A new variant of choanal polyps]
Extended frontal approach with bilateral orbitofrontoethmoidal osteotomies for removal of a giant extracranial schwannoma in the nasopharynx, sphenoid sinus, and parapharyngeal space.
[Lymphoma that is difficult to be differentiated from inflammatory diseases]
Glomangiomyoma of the nasal cavity.
CHOP followed by involved field radiation: is it optimal for localized nasal natural killer/T-cell lymphoma?
Unusually large cystic adenomatoid odontogenic tumour of the maxilla: case report.
IL-1 induced chemokine production through the association of Syk with TNF receptor-associated factor-6 in nasal fibroblast lines.
Evaluation of central nervous system involvement in nasal lymphomas.
[Psammomatoid ossifying fibroma]
[Expression of ras, p53, proliferating cell nuclear antigen in squamous cell carcinoma of maxillary sinus and their significance]
Anterior skull base trauma during endoscopic sinus surgery for nasal polyposis preferred sites for iatrogenic injuries.
The hinged-door composite septal flap as structural support and lining of nasal reconstruction by a forehead flap.
Neuroendocrine carcinoma of the sphenoid sinus: a case report.
Pleomorphic adenoma of the nose.
Topical corticosteroids in nasal polyposis.
[Malignant melanoma of the nasal cavity. Retrospective study. The analysis of p53 and p16INK4 expression]
[Angiocentric T/NK cell lymphoma: a special clinical-pathological entity of lethal midline granuloma. A case report]
[Ethmoid adenocarcinomas: retrospective study of 76 patients]
Olfactory neuroblastoma (esthesioneuroblastoma): report of six cases treated by a novel combination of endoscopic surgery and radiosurgery.
Increasing diagnostic yield in allergic fungal sinusitis.
Open septorhinoplasty approach for the excision of a dermoid cyst and sinus with primary dorsal reconstruction.
Nasal polyps removed for histological examination.
Clinical and histopathological correlation of nasal polyps: are there any surprises?

CancerMail from the National Cancer Institute

1
UI - 21236991
AU - Dong C; Hemminki K
TI - Risk of multiple primary cancers in nasal cancer patients.
SO - Epidemiology 2001 May;12(3):367-9

2
UI - 21259359
AU - Alessandrini M; Nucci R; Giacomini PG; Federico F; Bruno E
TI - A case of solitary nasal schwannoma.
SO - An Otorrinolaringol Ibero Am 2001;28(2):201-8
AD - Department of Otolaryngology University of Rome Tor Vergata.
A case of solitary neurilemmoma is presented. The patient was a 35-year-old male with progressive nasal obstruction due to a neoformation of the left vestibule. After the surgery the pathological diagnosis was neurilemmoma.

3
UI - 21321920
AU - Jimenez Oliver V; Lazarich Valdes A; Davila Morillo A; Ruiz del Portal JM; Conde Jimenez M; Fernandez Ruiz E; Ruiz Rico R
TI - [Frontal ethmoid metastases of prostatic carcinoma. Report of one case and review of the literature]
SO - Acta Otorrinolaringol Esp 2001 Mar;52(2):151-4
AD - Servicio de ORL, Hospital Clinico Universitario Virgen de la Victoria, Campus de Teatinos, s/n. 29010 Malaga.
Prostatic metastases in the nose and paranasal sinuses are rare. Less than 100 cases have been reported in the literature. Kidney are the commonest site of primary tumour, followed by lung and breast. Only 10 cases have previously been reported in the world literature. Prostatic metastases have been mainly reported in the sphenoid sinus. This paper reports one case of metastases of prostatic carcinoma in the fronto-ethmoid sinus in a 72 years old male. The clinical picture includes acute fronto-ethmoid right sinusitis, severe exophthalmos and chemosis. The CT scan showed extensive soft tissue filling the maxillary, ethmoid cells, sphenoid and frontal right sinuses, with subdural abscess. Biopsies from the fronto-ethmoid mass showed infiltration by adenocarcinoma with positive immunostaining for prostatic specific antigen. We also review the literature about metastases involving the nose and paranasal sinuses.

4
UI - 21320267
AU - Esteve E; Martin L; Georgescu V; Remy R
TI - [Basocellular carcinoma and congenital angiomatosis]
SO - Ann Dermatol Venereol 2001 May;128(5):687
AD - Service de Dermatologie, CHR Orleans, France.

5
UI - 21385083
AU - Kondo S; Yoshizaki T; Minato H; Horikawa I; Tatsumi A; Furukawa M
TI - Myofibrosarcoma of the nasal cavity and paranasal sinus.
SO - Histopathology 2001 Aug;39(2):216-7

6
UI - 21404637
AU - Cheung K; Lee TJ
TI - Craniopharyngioma involving supfrasellar region and sphenoid sinus: case report.
SO - Chang Gung Med J 2001 Jun;24(6):383-7
AD - Department of Otolaryngology, Chang Gung Memorial Hospital, Fu-Shin Street, Kweishan, Taoyuan, Taiwan, R.O.C.
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.

7
UI - 21411571
AU - Wong KF; So CC; Wong N; Siu LL; Kwong YL; Chan JK
TI - Sinonasal angiosarcoma with marrow involvement at presentation mimicking malignant lymphoma: cytogenetic analysis using multiple techniques.
SO - Cancer Genet Cytogenet 2001 Aug;129(1):64-8
AD - Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, SAR, Hong Kong, China. kfwong@ha.org.hk
Angiosarcoma of the head and neck most commonly involves the skin of the scalp or face; primary involvement of the sinonasal region is exceedingly rate. We report a patient with sinonasal angiosarcoma who showed marrow involvement at presentation. Marrow aspiration smears showed many large, often segregated blast-like cells, mimicking malignant lymphoma. However, trephine biopsy revealed formation of anastomosing vascular spaces by the tumor cells and immunoreactivity for CD31, supporting a diagnosis of angiosarcoma. DNA ploidy analysis showed an apparent diploidy. Nevertheless, conventional cytogenetics demonstrated very complex chromosomal abnormalities with the presence of multiple hypodiploid clones, together with several near-triploid to near-tetraploid clones showing structural abnormalities involving chromosomes 1, 3, 4, 9, 14, 16, 17, 18, and 22. The identification of these karyotypic changes has been facilitated by the application of comparative genomic hybridization and spectral karyotyping.

8
UI - 21140595
AU - Nishio S; Samoto K; Takeshita I; Matsumoto K; Matsushima T; Fukui M
TI - Inverting papilloma of the sphenoid sinus: report of two cases.
SO - J Clin Neurosci 2001 Mar;8(2):168-70
AD - Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. shunji@ns.med.kyushu-u.ac.jp
Two patients with sphenoid sinus inverting papilloma who were treated either by transcranial or sublabial trans-septal approach are reported. Inverting papillomas arising from the sphenoid sinus are exceedingly rare. The clinical and neuro-imaging features, as well as surgical treatment, for sphenoid sinus tumours are also briefly discussed. Copyright 2001 Harcourt Publishers Ltd.

9
UI - 21237223
AU - Lopatin AS; Shestakova IN
TI - [A new variant of choanal polyps]
SO - Vestn Otorinolaringol 2001;(2):11-4
Seven cases of ethmochoanal polyps, a form of nasal polyps, originating from mucosa of the back ethmoidal labyrinth and lowering into the nasopharynx are described. Such polyps are diagnosed primarily by computed tomography and endoscopy of the nasal cavity. Histologically, ethmochoanal polyps are similar to other polyps from paranasal sinuses. Surgical treatment of ethmochoanal polyps is made under the control of endoscope via approach through the superior nasal passage. The polyp part situated in posterior compartment of the ethmoidal labyrinth was removed with a microdebrider. 1 to 3 year follow-up registered no cases of recurrence.

10
UI - 21408606
AU - Schwartz TH; Bruce JN
TI - Extended frontal approach with bilateral orbitofrontoethmoidal osteotomies for removal of a giant extracranial schwannoma in the nasopharynx, sphenoid sinus, and parapharyngeal space.
SO - Surg Neurol 2001 May;55(5):270-4
AD - Department of Neurological Surgery, New York Presbyterian Hospital, New York, New York 10021, USA.
BACKGROUND: Although parapharyngeal schwannomas are not uncommon, schwannomas of the nasopharynx and paranasal sinuses are rare lesions. In the absence of intracranial extension, they are usually removed with transantral, lateral rhinotomy or more complex transfacial approaches. CASE DESCRIPTION: We report a 24-year-old patient with a giant benign schwannoma involving the superior parapharyngeal space, pterygopalatine fossa, nasopharynx, and sphenoid sinus with erosion into the clivus that was removed with an extended frontal approach including bilateral orbitofrontoethmoidal osteotomies. CONCLUSION: The advantages of the extended subfrontal over more standard transfacial approaches for lesions in this location include the early dissection of critical neural structures, preserving cosmetics and facilitating management of an inadvertent cerebrospinal fluid leak.

11
UI - 21353433
AU - Suzumiya J; Tamura K; Oshima K; Kikuchi M
TI - [Lymphoma that is difficult to be differentiated from inflammatory diseases]
SO - Nippon Naika Gakkai Zasshi 2001 Jun 10;90(6):1024-9

12
UI - 21356219
AU - Shek TW; Hui Y
TI - Glomangiomyoma of the nasal cavity.
SO - Am J Otolaryngol 2001 Jul-Aug;22(4):282-5
AD - Department of Pathology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Glomus tumor is a rare neoplasm that typically occurs in soft tissue of the extremity, particularly the subungual region of the finger tip. It rarely occurs in the nasal septum. Glomangiomyoma is a rare histologic variant of glomus tumor. The authors describe a case of glomangiomyoma of the nasal septum that presented as nasal obstruction. The histologic, immunohistochemical, and electronmicroscopic findings are described. The otolaryngologist and surgical pathologist should be aware of such an entity, and should not confuse it with the totally unrelated glomus jugulare tumor, or paraganglioma of the middle ear.

13
UI - 21230829
AU - Kim WS; Song SY; Ahn YC; Ko YH; Baek CH; Kim DY; Yoon SS; Lee HG; Kang WK; Lee HJ; Park CH; Park K
TI - CHOP followed by involved field radiation: is it optimal for localized nasal natural killer/T-cell lymphoma?
SO - Ann Oncol 2001 Mar;12(3):349-52
AD - Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-Ku, Seoul, Korea.
The present study aimed to analyse the treatment outcome of four cycles of CHOP (cyclophosphamide-vincristine-doxorubicin-prednisolone) followed by involved field radiation therapy (IF RT) for the treatment of stage I-II nasal natural killer (NK)/T-cell lymphoma. From March 1995 to December 1999, 17 patients (median age 41 years; range 30-66) with localized nasal NK/T-cell lymphoma were enrolled. B symptoms were noted in five patients (31%). Sixteen of seventeen patients (94%) were of low risk when classified according to the International Prognostic Index (IPI). The treatment plan consisted of four cycles of CHOP chemotherapy followed by IF RT of 45 Gy. Two patients received radiation during the first or second cycle of CHOP because of bleeding from the primary tumour site. Both patients achieved complete responses (CRs). In the remaining 15 patients, after 4 cycles of CHOP, 6 CRs and 3 partial responses (PRs) were achieved (53% of response rate). IF RT was given to six patients (four in CR, one in PR and one in PD), and all six patients achieved CR. Overall, CR was achieved in 10 of 17 patients (58%). The planned sequential chemoradiotherapy was completed in only 6 of 17 patients (35%) because of the progression during chemotherapy. None of the patients who achieved CR experienced relapse of lymphoma during follow-up. The estimated overall three-year survival rate was 59%. In univariate analysis, B symptoms and stage were significant prognostic factors for response and overall survival (P < 0.05). The present study suggests that four cycles of CHOP followed by IF RT is not satisfactory for treating patients with localized nasal NK/T-cell lymphoma, and that further exploration for improved therapy is needed.

14
UI - 21298283
AU - Takahashi K; Yoshino T; Hashimoto S
TI - Unusually large cystic adenomatoid odontogenic tumour of the maxilla: case report.
SO - Int J Oral Maxillofac Surg 2001 Apr;30(2):173-5
AD - Division of Oral Surgery, Social Insurance Funabashi Central Hospital, Japan. arlo@air.linkclub.or.jp
Adenomatoid odontogenic tumour (AOT) of the maxillary sinus is extremely rare. A case of a gigantic AOT that occupied the maxillary sinus is described.

15
UI - 21311883
AU - Yamada T; Fujieda S; Yanagi S; Yamamura H; Inatome R; Yamamoto H; Igawa H; Saito H
TI - IL-1 induced chemokine production through the association of Syk with TNF receptor-associated factor-6 in nasal fibroblast lines.
SO - J Immunol 2001 Jul 1;167(1):283-8
AD - Department of Otorhinolaryngology, Fukui Medical University, Fukui, Japan.
The fibroblasts stimulated by cytokines released the chemokine and recruited the infiltrating cells, including eosinophils, that play a key role in the pathogenesis of airway disease. We established the human fibroblast lines showing high Syk expression and the lines showing low Syk expression from pieces of nasal polyp. IL-1 induces the interaction of TNFR-associated factor (TRAF) 6 with IL-1R-associated kinase, which is rapidly recruited to the IL-1R after IL-1 induction, whereas TRAF2 participates in TNF-alpha-signaling. In the present study, we found that Syk played a different role in IL-1- and TNF-alpha-induced chemokine production through a signaling complex involving Syk and TRAF6. Overexpression of wild-type Syk by gene transfer enhanced RANTES production from nasal fibroblasts stimulated with IL-1. The decrease of Syk expression by the administration of Syk antisense inhibited RANTES production in response to IL-1. However, the change of Syk expression did not affect RANTES production by TNF-alpha stimulation. We concluded that Syk is required for the IL-1-induced chemokine production through the association with TRAF-6 in fibroblasts of nasal polyps.

16
UI - 21388473
AU - Shikama N; Oguchi M; Sasaki S; Shinoda A; Nishikawa A; Arakawa K; Koiwai K; Mochizuki K; Yamada A; Watanabe T; Kadoya M
TI - Evaluation of central nervous system involvement in nasal lymphomas.
SO - Nippon Igaku Hoshasen Gakkai Zasshi 2001 Jun;61(7):342-6
AD - Department of Radiology, Shinshu University, School of Medicine, Naoto Shikama.
OBJECTIVES: To clarify the usefulness of evaluating central nervous system (CNS) involvement in patients with nasal lymphomas at the initial staging procedure, and of CNS prophylaxis for patients with clinical stage I/II. PATIENTS AND METHODS: We retrospectively reviewed 43 patients with nasal lymphomas who had been treated from 1973 through 1999. The staging procedure included mainly computed tomography (CT), ultrasonography, gallium scintigraphy, upper gastrointestinal study, magnetic resonance (MR) imaging, and bone marrow biopsy. Forty-two patients received radiotherapy, and 25 patients received chemotherapy. All 38 patients with stage I/II were not subjected to CNS prophylaxis. RESULTS: Four patients demonstrated CNS involvement at the staging procedure. MR imaging demonstrated the tumor had directly infiltrated the skull base in 3 patients, but CT demonstrated CNS infiltration in only one patient. In another patient, cerebrospinal fluid (CSF) cytologic analyses demonstrated CNS involvement, but MR imaging and CT did not. These 4 patients complained of frontonasal pain and/or cerebral nerve dysfunction. No patient with stage I/II developed CNS relapse. CONCLUSIONS: MR imaging and CSF cytologic analyses should be performed at the initial staging of nasal lymphomas, especially in patients with frontonasal pain and/or cerebral nerve dysfunction. Patients with stage I/II might not need CNS prophylaxis.

17
UI - 21390887
AU - Lu Z; Wang Y; Zhang S
TI - [Psammomatoid ossifying fibroma]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Apr;33(2):100-2
AD - Tongren Hospital, Capital Medical University, Beijing, 100730.
OBJECTIVE: To clarify the histopathological, clinical behavior biological characterics and the relationship among the psammomatoid ossifying fibroma (POF), ossifying fibroma and fibrous dysplasia of bone. METHODS: Thirty-one cases of POF in the ear and sinonasal region were studied retrospectively. The sections, clinicopathological records from June, 1956 to November, 1996 were reviewed. The reticulum fiber and Masson's stain and alkaline phosphatase immunostain were done in 10 cases, Vimentin, Desmin, EMA and smooth actin immunohistochemical stain were done in 5 cases. One case was studied by transmission electron microscope. RESULTS: The specimens were broken tissue with the sand-like felling, eleven specimens with intact thin shell consisted of bone tissue were used to study the changes in the area between tumor and normal bone. Histopathologically they were rich in mesenchymal tumor cells and a lot of calcifying psammomatoid-like osteoid and a few of calcified bodies similar to those described by Shafer, and the bony trabecula was not found in the center of the tumor. In addition, three zones were noted at the junction of normal bone and tumor, namely, the normal bone-reactive proliferative bone-tumor. In some cases, the reactive bony proliferation may be not marked. The normal bone adjacent to the tumor may be absorbed and disappeared, and were then replaced by the tumor, and finally led to tumor tissue invasion into the soft tissue, but the infiltration appearance is not present. CONCLUSION: POF is the slowly growing benign tumor and is different from ossifying fibroma and fibrous dysplasia of bone.

18
UI - 21390885
AU - Zhu D; Wang S; Wang W
TI - [Expression of ras, p53, proliferating cell nuclear antigen in squamous cell carcinoma of maxillary sinus and their significance]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Apr;33(2):94-6
AD - EENT Hospital of Shanghai Medical University, Shanghai, 200031.
OBJECTIVE: To determine the expression of ras, p53 and proliferating cell nuclear antigen (PCNA) in squamous cell carcinoma(SCC), inverting papilloma(IP), inflammatory mucosa(IM) of maxillary sinus and analyze the correlation between their expression and the clinicopathological characters and prognosis of SCC of maxillary sinus(SCCMS). METHODS: Expression of ras, p53 and PCNA was determined in 40 cases of SCC, 20 cases of IP and 10 cases of IM of maxillary sinus with immunohistochemical technique. RESULTS: Expression of ras was correlated with differentiation of SCCMS, it was more frequent in well differentiated SCC than in poorly differentiated SCC. Expression of p53 was only present in SCCMS, there was not expression of p53 in IP and IM of maxillary sinus. The patients with high PCNA index SCCMS had a poorer prognosis than those with low PCNA index in SCCMS. CONCLUSION: p53 protein may be a diagnostic marker in SCCMS. Measurement of PCNA index may be helpful in estimating prognosis and directing clinical treatment in SCCMS.

19
UI - 21239371
AU - Grevers G
TI - Anterior skull base trauma during endoscopic sinus surgery for nasal polyposis preferred sites for iatrogenic injuries.
SO - Rhinology 2001 Mar;39(1):1-4
AD - Department of Otorhinolaryngology, Head and Neck Surgery, University of Munich, Munich, Germany. grevers@gmx.de
OBJECTIVE: To determine typical locations for traumatic lesions of the anterior skull base during endoscopic sinus surgery. STUDY DESIGN: In this retrospective study 12 patients were included who had undergone endoscopic sinus surgery for nasal polyposis and were referred to the author for revision surgery after iatrogenic trauma of the anterior skull base during the procedure. Each patient had been operated by a different surgeon, all of the physicians being in an advanced stage of their surgical career and being board certified otolaryngologists. RESULTS: During endoscopically controlled revision surgery, all lesions could be detected, 10 of them being located in the ethmoid roof, while one injury had occurred in the lateral lamella of the cribriform plate and another one in the olfactory groove between the medial turbinate and the nasal septum. CONCLUSION: In contrast to reports in the literature, the preferred site for anterior skull base injuries during endoscopic sinus surgery in our group was not the lateral lamella of the cribriform plate, but the anterior part of the ethmoid roof, just behind the frontal recess. Apparently the course of the ethmoid roof might be misinterpreted during sinus surgery even by surgeons who are familiar with the operative technique.

20
UI - 21239372
AU - Westerveld GJ; Middelweerd RJ; Leemans CR
TI - The hinged-door composite septal flap as structural support and lining of nasal reconstruction by a forehead flap.
SO - Rhinology 2001 Mar;39(1):5-8
AD - Department of Otolaryngology-Head and Neck Surgery, University Hospital Vrije Universiteit, Amsterdam, The Netherlands. gj.westerveld@azvu.nl
In this paper we describe four patients who underwent extensive nasal surgery for carcinoma in the nasal vestibule. Two patients underwent salvage surgery after radiotherapy, whereas the other two patients were treated with primary surgery. In all cases the nasal defect was reconstructed using a composite hinged-door septal flap for structural support and internal lining combined with a paramedian forehead flap which supplied the skin coverage. All patients had a pleasing aesthetic and good functional result. The combination of a paramedian forehead flap with a composite hinged-door septal flap is an excellent reconstruction procedure for defects of the lateral nasal wall and alar region.

21
UI - 21239383
AU - Westerveld GJ; van Diest PJ; van Nieuwkerk EB
TI - Neuroendocrine carcinoma of the sphenoid sinus: a case report.
SO - Rhinology 2001 Mar;39(1):52-4
AD - gj.westerveld@azvu.nl
The presentation of a neuroendocrine carcinoma in the paranasal sinuses is extremely rare. Until now only 25 cases have been reported in the literature. We report a case of a 65-year-old male with an atypical carcinoid of the sphenoid sinus which seemed to be associated with multiple endocrine neoplasia type 1 (MEN 1). To the best of our knowledge this is the first report on an atypical carcinoid in the sphenoid sinus.

22
UI - 21239384
AU - Yiotakis I; Dinopoulou D; Ferekidis E; Manolopoulos L; Adamopoulos G
TI - Pleomorphic adenoma of the nose.
SO - Rhinology 2001 Mar;39(1):55-7
AD - E.N.T. Department of Athens University, Hippokration General Hospital, Athens, Greece. jyiot@otenet.gr
Pleomorphic adenoma is the most frequent tumor of the major salivary glands. It is rarely located in the lacrymal glands and is unusual in the nasal cavity. A rare case of a pleomorphic adenoma of the nose is presented along with a review of the literature. The use of nasal endoscopy in removing tumors of the nose and paranasal sinuses is discussed.

23
UI - 21260579
AU - Badia L; Lund V
TI - Topical corticosteroids in nasal polyposis.
SO - Drugs 2001;61(5):573-8
AD - Professorial Unit, Institute of Laryngology and Otology, Royal National Throat, Nose and Ear Hospital, London, England.
Nasal polyps are the common end-point of a number of conditions characterised by inflammation and are rarely 'curable' in its true sense. After consideration of the underlying aetiology and confirmation of the diagnosis, they are normally managed by a combination of medical and surgical interventions. Of these, topical corticosteroids have proved to be the medical treatment of choice. The objectives of the medical management are to eliminate or reduce the size of polyps, re-establish nasal airway and nasal breathing, improve or restore the sense of smell, and prevent recurrence of nasal polyps. The mechanism of action of corticosteroids may be by a multifactorial effect on various aspects of the inflammatory reaction, the effect being initiated by their binding to a specific cytoplasmic glucocorticoid receptor. At a cellular level, there is a reduction in the number of antigen-presenting cells, in the number and activation of T cells, in the number of mast cells, and in the number and activation of eosinophils. When polyps are large (grade 3) topical medication is difficult to instil in a very blocked nose and surgery or short term systemic corticosteroids may be required. Topical corticosteroids are of use in the primary treatment of nasal polyps when they are of a small or medium size (grades 1 and 2) and in the maintenance of any therapeutic improvement. The efficacy of topical corticosteroids such as betamethasone sodium phosphate nose drops, beclomethasone dipropionate, fluticasone propionate and budesonide nasal sprays in reducing polyp size and rhinitis symptoms has been demonstrated in several randomised, placebo-controlled trials. Beclomethasone dipropionate, flunisolide and budesonide sprays have also been shown to delay the recurrence of polyps after surgery. Placebo-controlled studies of agents that have shown a significant clinical effect in the management of nasal polyposis are reviewed.

24
UI - 21349559
AU - Padilla Parrado M; Saez Castillo AI; Galan Morales JT; Orradre Romeo JL; Delgado Quero AL; Sanchez Carrion S
TI - [Malignant melanoma of the nasal cavity. Retrospective study. The analysis of p53 and p16INK4 expression]
SO - An Otorrinolaringol Ibero Am 2001;28(3):303-16
AD - Hospital Virgen de La Salud, Toledo.
Five cases of malignant melanomata of the nasal cavities have been diagnosed and studied at ENT--and Anatomopathological Departments, between 1990 and 1997, the group ranging from 65 to 90 years, middle age 74.2. Paramount symptoms were epistaxis and lack of pain in all patients. Radical surgery was performed only in one case, followed by radiotherapy; the remainder were submitted to palliative treatment. We have reviewed the literature and also an immunohistochemical analysis about p53, p16INK4 and Rb oncogenes with the aim to establish its importance in these tumor's type. The whole group have showed high levels of p53 and MIB-1 and 60 percent a loss of oncogen p16 expression.

25
UI - 21381138
AU - Koch M; Blatterspiel GJ; Niedobitek G; Constantinidis J
TI - [Angiocentric T/NK cell lymphoma: a special clinical-pathological entity of lethal midline granuloma. A case report]
SO - Laryngorhinootologie 2001 Jul;80(7):410-5
AD - Klinik und Poliklinik fur Hals-Nasen-Ohren-Heilkunde, Universitat Erlangen-Nurnberg. Michael-Koch@rzmail.uni-erlangen.de
BACKGROUND: The term "midline granuloma syndrome" (MGS) is a clinical description of a broad spectrum of diseases, which are characterised by aggressive and progressive destruction of mucosa and adjacent structures of the midface and upper aerodigestive tract. After exclusion of granulomatous infections, rare granulomatous diseases and epithelial neoplasias, the differential diagnosis includes the following entities: Wegener's granulomatosis (WG), malignant lymphoma and idiopathic midline destructive disease (IMDD). Today there are doubts about the existence of IMDD. After exclusion of WG nearly all remaining cases presenting as MGS are peripheral sinonasal angiocentric T- and/or NK-cell lymphomas, which show a close association to Epstein-Barr virus infection and now are recognised as a special clinicopathological entity. The natural history of these lymphomas is characterised through a rapidly progressive course with a poor prognosis. PATIENT: A case of a 35-year-old male patient with an angiocentric nasal T/NK-cell lymphoma, which involved the left lacrimal cyst, the left maxillar and ethmoid sinus as well as the soft and hard palates, is presented. First clinical signs and symptoms were similar to chronic-recurrent sinusitis. For almost two years the patient was treated with systemic corticoids for suspected limited Wegener's granulomatosis. The patient underwent sinus surgery for pansinusitis three times. After development of midline destructive disease the diagnosis of angiocentric lymphoma was established. RESULTS: Soon after the diagnosis a combination high-dose radiochemotherapy was performed. The patient died only 3 months later because of multiorgan failure. CONCLUSIONS: Because of its poor prognosis the angiocentric nasal NK/T-cell lymphoma should included early into the differential diagnosis of the midline granuloma syndrome. Correct biopsy technic and in situ hybridization of EBV can be important for an early diagnosis. Therapy should be aggressive and consists of high-dose radiotherapy, which is most important to reach local tumor control, and combination chemotherapy, the use of which is presently in discussion.

26
UI - 21391260
AU - Stoll D; Bebear JP; Truilhe Y; Darrouzet V; David N
TI - [Ethmoid adenocarcinomas: retrospective study of 76 patients]
SO - Rev Laryngol Otol Rhinol (Bord) 2001;122(1):21-9
AD - C.H.U. Pellegrin, Clinique Universitaire O.R.L., Place Amelie Raba Leon, 33076 Bordeaux, France.
From the retrospective study of 76 adenocarcinomas of the ethmoid sinuses, results were expressed in two terms: the morbidity related to surgery and the oncologic outcome. This case study extends between 1975 and 2000. It includes 71 men and 5 women, with an average of 61 years. 81% of them works in wood dust, with a mean duration of exposure of 26 years. The diagnosis of adenocarcinoma is realized in the three months after the first signs, essentially rhinologicals, next neurologicals and ophthalmologicals. The majority of tumors were classified as T3N0M0, i.e. 57.89%. The treatment of this tumors is surgical: 34.2% surgical only and 59.2% with radiotherapy. The transfacial approach (paralateronasal and degloving) and the combined surgery are respectively performed in 36 patients and 35 patients. 23.2% patients had a local recurrence, and 10% developed cervical nodes and systemic metastasis. Survival rate based on the Kaplan-Meier actuarial method is 82% at 3 years, 80% at 5 years, 72% at 10 years. The prognosis of ethmoidal cancer is strictly correlated to local control. Local recurrence is statistically more likely in patients with involvement of the dura, brain and sphenoid sinus. With the analysis of the carcinologics results, we discuss the therapeutics indications of the adenocarcinomas and a new classification. Taking in account the involvement of the dura, sphenoid and orbit. We did not find any statistical differences between T3 patients treated by combined approach (n = 13) or by transfacial approach (n = 15).

27
UI - 21380384
AU - Unger F; Walch C; Stammberger H; Papaefthymiou G; Haselsberger K; Pendl G
TI - Olfactory neuroblastoma (esthesioneuroblastoma): report of six cases treated by a novel combination of endoscopic surgery and radiosurgery.
SO - Minim Invasive Neurosurg 2001 Jun;44(2):79-84
AD - Department of Neurosurgery, Karl-Franzens University, Graz, Austria. frank.unger@lkh-graz.or.at
Microsurgical techniques have considerably improved the results of surgical treatment for esthesioneuroblastoma (olfactory neuroblastoma). Nevertheless, these rare tumours of the frontal skull base are still associated with high rates of tumour recurrence and mortality, thus remaining a challenge even for experienced surgeons. A novel therapeutic approach that combines endoscopic sinus surgery and radiosurgery (gamma knife) is presented here. Six patients (3 males, 3 females) aged between 27 and 75 years (median 38 years) were treated between August 1993 and July 1999. Following paranasal and nasal endoscopic sinus surgery, marginal irradiation doses ranging from 16 to 34 Gy were applied radiosurgically involving up to 7 isocentres. At present, the median follow-up period is 57 months (range: 9 - 79 months). Without mortality, tumour control was achieved in all patients. One patient, who had to undergo additional craniotomy because of extensive neoplastic infiltration, developed postoperative liquorrhea. In another case the clinical course was complicated by a bilateral frontal sinusitis. All patients complained of nasal discharge and crusts. However, a preoperative Karnovsky Index ranging from 80 to 100 % remained stable in four patients whereas an improvement was observed in two patients. Based on the favourable results observed so far, the combination of endoscopic sinus surgery and radiosurgery can be considered as promising new option for the treatment of esthesioneuroblastoma that merits further investigation.

28
UI - 21427061
AU - Rupa V; Jacob M; Matthews MS
TI - Increasing diagnostic yield in allergic fungal sinusitis.
SO - J Laryngol Otol 2001 Aug;115(8):636-8
AD - Department of ENT, Christian Medical College & Hospital, Vellore, India. rupavedantam@hotmail.com
Diagnosis of allergic fungal sinusitis (AFS) in patients who present with rhinosinusitis and polyposis is based upon certain clinical, histopathological and mycological histopathological criteria are the demonstration of fungal hyphae in allergic mucin and absence of tissue invasion in the excised polyps. Previous reports have indicated difficulty in demonstrating fungal hyphae on histological examination in up to 75 per cent of cases. Analysis of a series of 25 patients with AFS, suggested methods to ensure demonstration of fungal hyphae and thus increase diagnostic yield in cases with suspected AFS. criteria. Specific diagnostic

29
UI - 21427068
AU - Loke DK; Woolford TJ
TI - Open septorhinoplasty approach for the excision of a dermoid cyst and sinus with primary dorsal reconstruction.
SO - J Laryngol Otol 2001 Aug;115(8):657-9
AD - Department of Otorhinolaryngology, Royal Hallamshire Hospital, Sheffield, UK.
Adult nasal dermoid cysts and sinuses are rare. Here we describe the surgical management of a 37-year-old patient with a longstanding nasal dermoid cyst and discharging sinus. A combination of an open rhinoplasty approach with a small dorsal incision was used to excise the lesion followed by primary reconstruction with septal cartilage.

30
UI - 21429782
AU - Pahor AL
TI - Nasal polyps removed for histological examination.
SO - J Laryngol Otol 2001 Aug;115(8):687

31
UI - 21443356
AU - Kale SU; Mohite U; Rowlands D; Drake-Lee AB
TI - Clinical and histopathological correlation of nasal polyps: are there any surprises?
SO - Clin Otolaryngol 2001 Aug;26(4):321-3
AD - Department of Otolaryngology and Department of Pathology, University Hospital, Birmingham, UK. asu.kale@ukgateway.net
Nasal polypectomy is a common operation. There is debate about whether all nasal polyps removed at operation should be sent for histopathological examination. To investigate this, a prospective study was performed to check the correlation of clinical and histopathological examination. Three hundred and forty-four nasal polypectomy specimens during the period from September 1997 to September 1999 were sent for histopathological diagnosis, with the clinical diagnosis documented on the pathology form. The clinical diagnosis was then correlated with the histological diagnosis. Three hundred and twenty-eight specimens were diagnosed as inflammatory polyps and 16 as tumours, of which seven were malignant. There was a good correlation between the clinical and histological findings in 340 cases. There was disagreement between the forms and reports in four cases. When the notes were consulted, three cases had forms that were incorrectly filled in. There was only one unsuspected case of inverted papilloma in a polyp specimen, which looked like a benign inflammatory polyp. This study indicates there is a 99.7% correlation between clinical and histopathological diagnosis.