National Cancer Institute®
Last Modified: February 1, 2002
UI - 11685963
AU - Mevio E; Bignami M; Luinetti O; Villani L
TI - Nasal paraganglioma. A case report.
SO - Acta Otorhinolaryngol Belg 2001;55(3):247-9
AD - Service de ORL, Hopital G. Fornaroli, Magenta (Mi), Pavia, Italy. email@example.com
Nasal paraganglioma. A case report. Nonchromaffin paragangliomas or chemodectomas arise in paraganglia distributed in various parts of the body. The jugular bulb, the vagal body and the bifurcation of the carotid artery are the most common sites of origin of paraganglioma in the head and neck region. Paragangliomas in the nose and paranasal sinuses are extremely rare and very few cases of definite paraganglioma arising primarily in the nose or paranasal sinuses have been reported. The paraganglioma is a slow-growing tumour that produces nasal obstruction, profuse epistaxis and facial swelling. Complete excision of the glomus tumour is normally curative. We report a case of nasal paraganglioma and discuss the diagnosis and therapy.
UI - 11685964
AU - Monserez D; Vlaminck S; Kuhweide R; Casselman J
TI - Symmetrical ethmoidal metastases from ductal carcinoma of the breast, suggesting transcribrosal spread.
SO - Acta Otorhinolaryngol Belg 2001;55(3):251-7
AD - ENT Department, A.Z. St. Jan, Brugge, Belgium.
Symmetrical ethmoidal metastases from ductal carcinoma of the breast, suggesting transcribrosal spread. While half of breast cancers develop metastases, the appearance of metastatic disease in paranasal sinuses from this origin is very rare. Eighteen other cases were found in the literature, dating from 1939 till now. A case of metastatic breastcancer presenting as a subacute therapy-resistant pansinusitis is described. The perfect symmetry was misleading. Bilateral ethmoidal biopsies were compatible with metastases from a ductal adenocarcinoma. Further investigation revealed meningeal carcinomatosis in the supra-orbital region and locoregional recurrence in the mastectomy scar and axilla. Comparing these 19 cases in chronological order, it was noticed that symptoms at time of diagnosis shift from those of space occupying lesions to those suggestive for sinusitis. This shift could be explained by earlier diagnosis. High index of suspicion is the key to diagnosis. Earlier diagnosis does not result in longer survival since in most cases patients have already widespread disease and die within one year. Most authors mention the role of the vertebral venous plexus in hematogeneous spreading of tumor cells. Another pathway of hematogenous spread is via (occult) lung metastases. This case prompts the hypothesis of transcribrosal spread from meningeal involvement.
UI - 11774402
AU - Snyder ML; Paulino AF
TI - Melan-A as a useful diagnostic immunohistochemical stain for the diagnosis of primary sinonasal melanomas.
SO - Head Neck 2002 Jan;24(1):52-5
AD - Department of Pathology, University of Michigan Hospitals, 1500 East Medical Center Drive, Room 2G332, Ann Arbor, MI 48109, USA.
BACKGROUND: Sinonasal melanomas are rare neoplasms whose diagnosis may require confirmatory immunohistochemical stains. S-100 protein and HMB-45, the stains most commonly used, have varying sensitivities and specificities. Melan-A, a more recent melanoma-specific marker, may prove helpful when S-100 protein and HMB-45 stains are negative or equivocal. METHODS: Seven cases of sinonasal melanoma were assessed for reactivity with Melan-A, S-100 protein and HMB-45. RESULTS: The study group consisted of two women and five men ages 40 to 83. Six of the neoplasms were strongly positive for S-100 protein. One case was negative for S-100 protein and HMB-45 but positive for Melan-A. HMB-45 staining varied between diffusely positive (three cases), focally positive (two cases), and negative (two cases). All cases were positive for Melan-A either diffusely (four cases) or focally (three cases). CONCLUSION: Because Melan-A can be positive in cases that are S-100 protein or HMB-45 negative, it is a useful component in the immunohistochemical panel for the diagnosis of sinonasal melanomas. Copyright 2002 John Wiley & Sons, Inc.
UI - 11815971
AU - Yasumatsu R; Nakashima T; Kuratomi Y; Hirakawa N; Azuma K; Tomita K;
TI - Cataltepe S; Silverman GA; Clayman GL; Komiyama S Serum squamous cell carcinoma antigen is a useful biologic marker in patients with inverted papillomas of the sinonasal tract.
SO - Cancer 2002 Jan 1;94(1):152-8
AD - Department of Otorhinolaryngology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
BACKGROUND: Inverted papilloma (IP) is a frequent benign sinonasal tumor that is characterized histologically by squamous metaplasia, epithelial acanthosis, and hyperplasia of the nasal epithelium. Because of its high recurrence rate and malignant transformation potential, careful long-term follow up is necessary. METHODS: The purpose of the current report was to study the expression of squamous cell carcinoma (SCC) antigen in sinonasal IPs and to evaluate the usefulness of SCC antigen as a biologic marker for the follow-up of patients with sinonasal IP. The expression of SCCA1 in three sinonasal IP cases, three sinonasal SCC cases, and cases of normal nasal epithelium were examined by Western blot analysis, and the SCCA1 expression pattern in 31 IP specimens and 4 carcinoma in IP specimens were evaluated immunohistochemically. The serum levels of SCC antigen in 11 patients with sinonasal IP also were analyzed. RESULTS: SCCA1 was overexpressed in all three sinonasal IP tissues compared with sinonasal SCC tissues or normal nasal epithelium. SCCA1 cytoplasmic immunoreactivity was detected in the suprabasal epidermal keratinocytes of all 31 sinonasal IP cases. In the four carcinoma in IP specimens, SCCA1 expression in the papillomatous lesion was more intense than in the cancerous lesion. The serum SCC antigen level was high in 10 of 11 patients with IP (91%) and significantly decreased after surgical resection of the tumors. CONCLUSIONS: The results of the current study indicate that SCCA1 frequently is overexpressed and may play a biologic role in the development of sinonasal IPs. Serum SCC antigen may be a useful biologic marker in patients with sinonasal IP. Copyright 2002 American Cancer Society.
UI - 11554623
AU - Quraishi MS; Bessell EM; Clark DM; Jones NS; Bradley PJ
TI - Aggressive sino-nasal non-Hodgkin's lymphoma diagnosed in Nottinghamshire, UK, between 1987 and 1996.
SO - Clin Oncol (R Coll Radiol) 2001;13(4):269-72
AD - University Hospital, Nottingham, UK.
In the 10-year period 1987 to 1996, 24 patients were diagnosed with aggressive non-Hodgkin's lymphoma of the nasal cavities or paranasal sinuses. The disease occurred in a relatively elderly population of median age 72 years (range 42 to 96) with a male predominance (male 15; female nine). The histology on review was mostly of the large B-cell subtype (21 patients); peripheral T-cell subtype (one), anaplastic large cell of T-cell type (one) and T/natural killer cell nasal lymphoma (one). The disease was localized in 20 patients (Stage IEA). The overall survival at 5 years was 40% (95% confidence interval (CI) 19-61); at 10 years it was 33% (95% CI 12-54). The cause-specific survival (excluding deaths from causes other than lymphoma) at 5 years and 10 years was 62% (95% CI 39-86).
UI - 11730998
AU - Claus F; De Gersem W; Vanhoutte I; Duthoy W; Remouchamps V; De Wagter C;
TI - De Neve W Evaluation of a leaf position optimization tool for intensity modulated radiation therapy of head and neck cancer.
SO - Radiother Oncol 2001 Dec;61(3):281-6
AD - Division of Radiotherapy, Ghent University Hospital (GUH), De Pintelaan 185, 9000 Ghent, Belgium.
BACKGROUND AND PURPOSE: Since 1996, patients are treated at Ghent University Hospital with a multi-segment technique using MultiLeaf Collimators. The segments were obtained by using the Beam's eye view projections of the planning target volume (PTV) and the organs at risk (OARs), after which the segments weights were optimized. To investigate if optimization of the leaf positions would further improve the intensity modulated radiation therapy (IMRT) plans, a tool optimizing leaf positions and segment weights simultaneously, was developed. This tool is called SOWAT, which is the acronym for segment outline and weight adapting tool. MATERIAL AND METHODS: The tool evaluates the effects of changing the position of each collimating leaf of all segments on the value of the objective function. Only changes that improve the value of the objective function are retained. Between with IMRT. Two patient groups were distinguished: pharyngeal and laryngeal tumors (n=17) and sinonasal tumors (n=13). A specific set of physical endpoints was evaluated for each group. Dose statistics of the treatment plans without and with SOWAT were analyzed. RESULTS: When using SOWAT for the pharyngeal and laryngeal cases, the PTV dose homogeneity increased with a median of 11% (range 2-27%), while the maximum dose to the spinal cord was decreased for 14 of the 17 patients. In four plans where parotid function preservation was a goal, the parotid mean dose was lower than 26 Gy in one plan without SOWAT, and in four plans with SOWAT. For the sinonasal tumors, the PTV dose homogeneity increased with a median of 7% (range 1-14%). SOWAT lowered the mean dose to 53 of the 63 optic pathway structures (retina, optic nerve and optic chiasm). SOWAT leaves the number of segments unchanged and has little or no effect on the delivery time. CONCLUSIONS: SOWAT is a powerful tool to perform the final optimization of IMRT plans, without increasing the complexity of the plan or the delivery time.
UI - 11773735
AU - Pokorny JJ; Roth F; Balfour I; Rinehart G
TI - An unusual complication of the treatment of a hemangioma.
SO - Ann Plast Surg 2002 Jan;48(1):83-7
AD - Division of Plastic Surgery, St. Louis University Hospital, 3635 Vista at Grand Boulevard, St. Louis, MO 63110, USA.
A 3-month-old infant was administered high-dose systemic prednisolone for management of a hemangioma of the nasal sidewall. After 10 weeks of therapy, medical evaluation of weight loss disclosed hypertrophic obstructive cardiomyopathy. After discontinuation of the steroid, the cardiomyopathy resolved.
UI - 11802063
AU - Besancon-Watelet C; Bene MC; Montagne P; Faure GC; Jankowski R
TI - Eosinophilia and cell activation mediators in nasal secretions.
SO - Laryngoscope 2002 Jan;112(1):43-6
AD - Laboratoire d'Immunologie du CHU, Faculte de Medecine, 54505, Vandoeuvre-les-Nancy Cedex, France.
OBJECTIVES/HYPOTHESIS: In rhinologic disorders such as polyposis or rhinitis, nasal cytology allows differentiation between patients according to the degree of eosinophilia in nasal secretions. The egress of eosinophil and/or neutrophil polymorphonuclears from the underlying mucosa might correlate with the release of soluble mediators of cell activation such as the chemokine IL-8, and such molecules of the innate immunity as the LPS-receptor CD14 or lysozyme. We assayed the levels of these three molecules in nasal secretions in correlation with cytologic findings and especially the degree of eosinophilia. STUDY DESIGN: Fifty-four patients from a prospective study of nasal secretions were enrolled in this work. They constituted two groups of 27 patients each, respectively, with or without more than 20% eosinophils in nasal secretions. Nasal secretions were collected by aspiration, weighed and diluted in a fixed amount of buffer. Classic cytologic analyses were performed on the pelleted cells and IL-8, sCD14, and lysozyme levels were assayed in the cell-free supernatants. METHODS: Cytologic analyses included cell-enumeration in Neubauer's chambers, and differentials performed on May-Grunwald Giemsa-stained cytospins. ELISA tests were used to assay the levels of IL-8 and sCD14. Lysozyme concentrations were assayed in immuno-nephelometry. RESULTS: Significantly lower levels of IL-8 and sCD14 were observed in patients with eosinophilia than in patients with a predominance of neutrophils, whereas no difference was observed in lysozyme concentrations. CONCLUSION: These data show that the egress of neutrophils in nasal secretions is associated with high levels of IL-8 and sCD14.
UI - 11802038
AU - Takeno S; Hirakawa K; Ueda T; Furukido K; Osada R; Yajin K
TI - Nuclear factor-kappa B activation in the nasal polyp epithelium: relationship to local cytokine gene expression.
SO - Laryngoscope 2002 Jan;112(1):53-8
AD - Department of Otolaryngology, Hiroshima University School of Medicine, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan. Sachio.Takeno@ma2.seikyou.ne.jp
OBJECTIVES: A panel of cytokines has been found to be important for eosinophil accumulation and activation in nasal polyps. The aims of this study were to ascertain whether the activation of nuclear factor-kappa B (NF-kappaB) occurred in the polyp epithelium, and to examine the relationship between the degree of activation and local cytokine gene expression. STUDY DESIGN/METHODS: Nasal polyp specimens were obtained from 26 untreated patients. The proportion of nuclear translocation of the NF-kappaB p50 subunit in the polyp epithelium was quantitatively analyzed by a combination of fluorescent immunohistochemistry and a laser scanning confocal microscope image system. The levels of GM-CSF, IL-5, IL-8, IL-16, and eotaxin mRNA expression in the same speci-mens were measured using reverse transcription-polymerase chain reaction. RESULTS: Both cytoplasmic and nuclear localization of the p50 subunit was observed mainly in the epithelial layer in all specimens. The percentages of epithelial cells with nuclear translocation ranged from 4.5% to 40.5% (median, 18%). Significant correlations were observed between the degree of epithelial NF-kappaB activation and the levels of IL-8, IL-16, and eotaxin mRNA expression (r = 0.468, 0.47, and 0.739, respectively). CONCLUSION: The activation of NF-kappaB in the nasal polyp epithelium is responsible for the recruitment of inflammatory cells, particularly eosinophils, through the initiation of the transcriptional pathway of the related cytokines. The increased NF-kappaB activity in the polyp epithelium may reflect hypersensitivity to unknown stimuli.
UI - 11801944
AU - Hong SK; Min YG; Kim CN; Byun SW
TI - Endoscopic removal of the antral portion of antrochoanal polyp by powered instrumentation.
SO - Laryngoscope 2001 Oct;111(10):1774-8
AD - Department of Otolaryngology, College of Medicine, Ewha Women's University Mokdong Hospital, Seoul, Korea. firstname.lastname@example.org
OBJECTIVES: To introduce a new surgical technique for endoscopic removal of the antral portion of antrochoanal polyp (ACP) by powered instrumentation and to determine its efficacy by measures of relevant patient outcome. STUDY DESIGN: Prospective study in 28 patients undergoing endoscopic sinus surgery for ACP by our surgical technique. METHODS: Improvements of clinical symptoms and endoscopic and computed tomographic findings were evaluated postoperatively with a follow-up period ranging from 12 to 52 months. All symptom scores on a 100-mm visual analogue scale before operation were compared with those at the last visit after operation. Postoperative endoscopic and computed tomographic findings were graded using a three-point scale ranging from 0 to 2. In surgical technique, the antral portion of ACP was identified through the enlarged ostium under intranasal endoscopy and removed by a blade of powered instrumentation that was inserted through the canine fossa. RESULTS: Symptom scores were all significantly reduced postoperatively. All but one patient showed improvement in clinical symptoms and endoscopic and computed tomographic findings during the follow-up period. There were no major complications specific to this technique. CONCLUSION: Our technique provides an attractive alternative to other methods for removing the antral portion of an ACP and is associated with excellent outcomes and minimal morbidities.
UI - 11141953
AU - Caversaccio M; Hartnell A; Calnan D; Jose P; Mackay IS; Uguccioni M;
TI - Baggiolini M; Williams TJ; Conroy DM [The role of chemokines in nasal polyps]
SO - Schweiz Med Wochenschr 2000;Suppl 125():92S-95S
AD - Universitatsklinik fur HNO, Hals- und Kopfchirurgie, Inselspital Bern.
Nasal polyposis is an inflammatory condition of the nose and the sinuses characterised by a marked infiltration of eosinophils in addition to lymphocytes, mast cells and macrophages. The selective recruitment of eosinophils to inflammatory sites is mediated by CC chemokines such as Eotaxin and Eotaxin-2. In the present study histology, immunohistochemistry and ELISA were performed. The levels of Eotaxin and Eotaxin-2 and for comparison other chemokines RANTES and IL-8 were measured in nasal polyp tissue and in control nasal tissue. On histological examination 6 polyps showed an oedematous structure, one was glandular and one had a fibromatous pattern, while all showed a marked eosinophil infiltration. Immunohistochemistry of the polyps showed that epithelial cells were strongly positive for Eotaxin and IL-8, whereas endothelial cells stained positive for Eotaxin-2. Significantly higher amounts of Eotaxin, Eotaxin-2 and IL-8 were detected in polyp tissue when compared with control middle turbinates. The increased levels of eosinophil-stimulating chemokines, such as Eotaxin and Eotaxin-2 in nasal polyps suggest that they may be important regulators of eosinophil recruitment in this inflammatory disease.
UI - 11780191
AU - Zong Y; Liu K; Zhong B; Chen G; Wu W
TI - Epstein-Barr virus infection of sinonasal lymphoepithelial carcinoma in Guangzhou.
SO - Chin Med J (Engl) 2001 Feb;114(2):132-6
AD - Department of Pathology, Sun Yat-sen University of Medical Sciences, Guangzhou 510089, China. email@example.com
OBJECTIVES: To investigate the prevalence of sinonasal lymphoepithelial carcinoma (SNLEC) in Guangzhou, a high incidence area of nasopharyngeal carcinoma (NPC), and to detect whether it is associated with Epstein-Barr virus (EBV) infection. METHODS: Twenty confirmed SNLEC specimens were collected from all of the sinonasal carcinoma biopsies performed in the 8 years 1989-1996 at the Sun Yat-sen University of Medical Sciences. EBV encoded early RNAs were detected by use of in-situ hybridization. A variety of antigens, including the EBV nuclear antigen 1, latent membrane protein 1, BZLF1 protein, diffuse early antigen, viral capsid antigen and membrane antigen, were detected using immunohistochemistry. Additionally, 36 NPC specimens were used for comparison. RESULTS: Twenty SNLECs were identified. Seventeen SNLECs were developed in the nasal cavity, and 3 in the maxillary sinus. The mean age (46.25 y), male to female ratio (3:1), histopathology and lymphoinfiltration of the 20 SNLECs were identical with those of the 36 NPCs. Thirteen (65.0%) of the 20 SNLECs showed an expansive growth pattern, while 27 (75.0%) of the 36 NPCs showed an infiltrating or mixed growth pattern. The majority of cancer cells in all of the 20 SNLECs showed EBV encoded early RNAs. The EBV nuclear antigen 1 expression of SNLEC was less intensive than that of NPC. The expression rate of latent membrane protein 1 for SNLEC (3/20, 15%) was lower than that for NPC (19/36, 52.8%). The expression rates of BZLF1 protein (2/20, 10.0%), diffuse early antigen (19/20, 95.0%), viral capsid antigen (15/20, 75.0%), and membrane antigen (13/20, 65.0%) for SNLEC were higher than those (0/36, 0.0%; 31/36, 86.0%; 18/36, 50%; and 14/36, 38.9%) for NPC. CONCLUSIONS: SNLEC is not uncommon in Guangzhou. This tumour is also consistently associated with EBV infection like NPC. As compared to NPC, the EBV harbored in SNLECs seems to express the EBV nuclear antigen 1 weakly and has a lower expression rate of latent membrane protein 1 as well as higher expression rates of EBV lytic products.
UI - 11579720
AU - Mavragani CP; Paikos S; Doussis-Anagnostopoulou I; Voulgarelis M
TI - Midfacial swelling and oro-nasal involvement in a 53-year-old patient with bilateral pulmonary infiltrations.
SO - Clin Exp Rheumatol 2001 Sep-Oct;19(5):577-81
AD - Department of Pathophysiology, Medical School, National University of Athens, Greece.
UI - 11721507
AU - Keles N; Deger K
TI - Endonasal endoscopic surgical treatment of paranasal sinus inverted papilloma--first experiences.
SO - Rhinology 2001 Sep;39(3):156-9
AD - Department of ORL, Istanbul School of Medicine, Istanbul University, Turkey. firstname.lastname@example.org
PURPOSE: Surgical excision is generally regarded as the treatment of choice for inverted papilloma. However, the approach and extent of surgery has been subject of much debate. The purpose of this study is to evaluate the results of endoscopic sinus surgery in the treatment of paranasal sinus inverted papilloma. PATIENTS AND METHODS: Thirteen cases of inverted papilloma of the paranasal sinuses treated via endoscopic sinus surgery were evaluated. The follow-up averaged from 9 months to 48 months with a mean of 27 months. RESULTS: A close follow-up of all patients was maintained. Seventy-seven per cent (10/13) of the patients had no recurrence after the initial endoscopic procedure. Three patients had recurrences of their tumor within 11 months after surgery, which means a rate of 23% (3/13). In 2 patients, the recurrences were treated endoscopically. In one patient, recurrence and malignant transformation (squamous cell carcinoma) developed after 36 months, which means that the associated carcinoma rate was 7% (1/13). This patient underwent radical maxillectomy and postoperative radiotherapy. None of the patients died of inverted papilloma. CONCLUSION: Endoscopic sinus surgery is a viable treatment alternative for paranasal sinus inverted papilloma in selected cases. This approach should be performed by experienced surgeons and a close follow-up is mandatory. When the disease is more extensive, it should be approached by radical surgery, e.g. en-bloc excision by medial maxillectomy via lateral rhinotomy or mid-facial degloving.
UI - 11721510
AU - Yang TL; Hsu MC; Liu CM
TI - Nasal schwannoma: a case report and clinicopathologic analysis.
SO - Rhinology 2001 Sep;39(3):169-72
AD - Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
According to the literature, half of the schwannoma cases occur in the head and neck areas and only less than 4% occur in the sinonasal tract. In this case, a 39-year-old male patient, with a-year-long progressive left side nasal obstruction and purulent rhinorrhea, is presented. The CT reveals a mass filling the left nasal cavity and nasopharyngeal space, with bony erosion of the inferior turbinate and medial maxillary bone. During surgical intervention, the mass is found to originate from the medial side of the left middle turbinate with maxillary sinusitis and inferior turbinate atrophy. The pathological examination reveals a noncapsulated tumor with palisading cellular arrangement and high cellular density. The pathological findings and nervous origin of the tumor are discussed after an extensive review of the literature.
UI - 11719871
AU - Verney Y; Zanolla G; Teixeira R; Oliveira LC
TI - Midline nasal mass in infancy: a nasal glioma case report.
SO - Eur J Pediatr Surg 2001 Oct;11(5):324-7
AD - Service of Paediatric Surgery, University of Santa Maria, Santa Maria, Brazil. Yvelise@ccs.ufsm.br
Congenital midline nasal masses are rare anomalies that occur in about one in 20,000-40,000 live births. The most common are dermoid/epidermoid tumors, nasal cerebral heterotopias (nasal gliomas), and nasal encephaloceles; some have an actual or potential central nervous system connection. Nasal gliomas are CNS masses of neurogenic origin which have lost their intracranial connections and present as an obvious external or intranasal mass at birth without associated surgical symptoms. Careful evaluation is required to confirm the diagnosis and appropriate management. The interpretation of CT and MR images can be difficult but is useful in differentiating nasal gliomas from other congenital nasal masses. The presence of a fibrous stalk may be associated with cranial defects and CSF leak. Excisional biopsy allows histopathologic diagnosis and is the definitive treatment. They are benign lesions, and recurrences are rare, so conservative cosmetic surgical techniques should be chosen for gliomas where there is no proven intracranial extension. The authors report an illustrative nasal glioma case in a one-year-old male infant with extranasal and intranasal components, and discuss the therapeutic options.
UI - 11732819
AU - Orvidas LJ; Beatty CW; Weaver AL
TI - Antrochoanal polyps in children.
SO - Am J Rhinol 2001 Sep-Oct;15(5):321-5
AD - Department of Otorhinolaryngology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Although relatively rare, antrochoanal polyps represent one of the most common types of polyp diagnosed in children without cystic fibrosis. In an attempt to better define this entity and discuss treatment options, the histories and operative reports of all 25 children (aged 17 years and younger) diagnosed with an antrochoanal polyp between 1970 and 1997 at our institution were reviewed. All 25 children complained of nasal obstruction on presentation; other presenting symptoms included rhinorrhea (48%), snoring (36%), and mouth breathing (32%). All 25 patients were noted to have a mass in the nose on examination, and 16 (64%) also had a mass noted in the nasopharynx. All but 1 patient underwent surgical removal of the polyp: intranasal avulsion only, 2 patients; Caldwell-Luc procedures, 10 patients; intranasal procedures, 8 patients; and endoscopic procedures, 4 patients. Mean time to first recurrence was 44.5 months. Seven patients (29%) who underwent excision at our institution experienced recurrence, 3 after endoscopic procedures and 4 after intranasal procedures (with or without Caldwell-Luc; 1 of these patients had a second recurrence). Complications were unusual and included bleeding after pack removal (8.3%) and facial paresthesias (10%). Follow-up ranged from 2 days to almost 27 years and was aided by telephone interviews. We conclude that surgical treatment of these lesions is safe and effective. Endoscopic removal may result in a higher recurrence rate.
UI - 11732823
AU - Schwerer MJ; Sailer A; Kraft K; Baczako K; Maier H
TI - Differentiation-related p53 protein expression in nondysplastic sinonasal inverted papillomas.
SO - Am J Rhinol 2001 Sep-Oct;15(5):347-51
AD - Department of Pathology, Military Hospital Ulm, Ulm/Donau, Germany.
To clarify p53 protein expression in nondysplastic sinonasal inverted papillomas, archived surgical specimens from 19 patients were studied using immunohistochemistry. Staining results were compared between inverted papillomas and adjacent, nonpapillomatous nasal mucosa. Further, immunoreactivity was compared between columnar (respiratory), transitional (cuboidal), and squamous epithelium in inverted papillomas. Positive staining was found in 17 of 19 inverted papillomas (89%). Immunoreactivity involved predominantly basal and parabasal cells and was either comparable or higher in inverted papillomas compared with adjacent mucosa. In 65% of immunoreactive inverted papillomas comparable staining results were seen between columnar (respiratory), transitional (cuboidal), and squamous epithelium. In 35% of p53 protein-positive inverted papillomas, enhanced immunoreactivity was observed in transitional (cuboidal) and squamous epithelium compared with columnar (respiratory) epithelium. Within these cases, immunoreactivity was either comparable or higher in squamous compared with transitional (cuboidal) epithelium. Conclusively, the expression of p53 protein is present in 89% of nondysplastic sinonasal inverted papillomas and also involves the adjacent, nonpapillomatous nasal mucosa. A tendency toward increasing p53 protein expression from nonpapillomatous nasal mucosa to inverted papilloma as well as along the metaplastic process from columnar (respiratory) to transitional (cuboidal) and finally squamous epithelium within inverted papillomas can be postulated.
UI - 11801784
AU - Boyd AS; Zhang J
TI - Hemangioblastoma arising in the skin.
SO - Am J Dermatopathol 2001 Oct;23(5):482-4
AD - Department of Medicine (Dermatology), Vanderbilt University, Nashville, Tennessee 37232, USA. email@example.com
Hemangioblastomas are intracranial and intraspinal tumors arising sporadically or in patients with von Hippel-Lindau disease. To date, hemangioblastomas have not been described in the skin. Proliferating clear cells with a variable vascular component are found histologically. These clear cells stain for neuron-specific enolase but not cytokeratin or epithelial membrane antigen, allowing them to be differentiated from metastatic renal cell carcinoma.
UI - 11724258
AU - Prado GL; Itabashi Y; Noda H; Miura H; Mariya Y; Abe Y
TI - Olfactory neuroblastoma visualized by Technetium-99m-ECD SPECT.
SO - Radiat Med 2001 Sep-Oct;19(5):267-70
AD - Department of Radiology, Hirosaki University School of Medicine, Japan.
We describe a case of olfactory neuroblastoma diagnosed by 99mTc-ECD SPECT. Although MRI and CT are very important for delineating these tumors, they are, by no means, specific for neuroblastomas. 131I-MIBG scintigraphy, the standard method for imaging tumors of neural crest origin, also failed to detect a histologically proven esthesioneuroblastoma.
UI - 11810394
AU - Buhl R; Nabavi A; Fritsch M; Mehdorn HM
TI - Nasopharyngeal extension of a craniopharyngioma in a 4 year old girl.
SO - Acta Neurochir (Wien) 2001 Dec;143(12):1283-5
AD - Department of Neurosurgery, University of Kiel, Germany.
Nasopharyngeal extension of a craniopharyngioma is very rare and usually presents with headache, nasal obstruction and visual disturbances. We present a case of a 4 year old girl, who became symptomatic with visual deterioration. MRI showed a huge supra - and infrasellar cystic craniopharyngioma with extension into the sphenoid sinus. Primary treatment was a transnasal puncture of the cyst followed by a subfrontal approach with removal of the tumour preserving the chiasm and optic nerves. The visual acuity postoperatively improved while she needed hormone replacement due to panhypopituitarism. Follow-up 12 months after the operation showed no recurrence. This is the youngest patient of about 27 patients reported so far in the literature.
UI - 11796430
AU - Henriksson G; Westrin KM; Karpati F; Wikstrom AC; Stierna P; Hjelte L
TI - Nasal polyps in cystic fibrosis: clinical endoscopic study with nasal lavage fluid analysis.
SO - Chest 2002 Jan;121(1):40-7
AD - Department of Otolaryngology, Karolinska Institute, Huddinge University Hospital, Huddinge, Sweden. Gert.Henriksson@ent.hs.sll.se
STUDY OBJECTIVES: Nasal polyps frequently appear in patients with cystic fibrosis (CF). The aims of this study were to focus on what problems (symptoms, endoscopic findings, and laboratory correlates) nasal polyps cause the CF patient, and how these correlate to the total health situation of this patient group. PATIENTS AND STUDY DESIGN: The clinical histories, endoscopic investigations of the nasal cavity, and analyses of nasal lavage fluid of 44 patients with CF complicated with nasal polyposis have been compared with those of 67 CF control subjects. The patients were examined at annual control examinations (with pulmonary tests, working capacity, liver tests, and bacterial and blood tests) from 1995 to 1996 at Stockholm Cystic Fibrosis Center, Huddinge University Hospital. All patients were > 2 years of age. The endoscopic findings were related to the actual pulmonary function, inflammatory blood parameters, colonizing pathogens, antibodies (Staphylococcus aureus and Pseudomonas aeruginosa), and genotype. RESULTS: The patients with nasal polyps differed with respect to chronic colonization of P aeruginosa in sputum samples and had a higher occurrence of serum antibodies against the same species. The two groups did not differ in pulmonary functions, inflammatory parameters, or genotype. The polyps found were mainly small (within the meatus media) and gave no significant increase in ongoing clinical symptoms such as rhinorrhea, nasal obstruction, or hyposmia. Neither was any significantly marked finding concerning the nose (mucosal swellings, secretion, etc.) made in the polyp patients. The patients with CF scored slightly lower in a smell identification test in comparison with the healthy control group. The nasal lavage fluid was analyzed (in 93 of the 111 patients) for the occurrence of P aeruginosa (by polymerase-chain reaction [PCR]), interleukin [IL]-5, IL-8, and lysozyme. The lysozyme and IL-8 content was equal in the two CF groups but increased in comparison with the healthy control group. P aeruginosa was not detected with PCR in any nasal lavage fluid. No measurable levels of IL-5 in the nasal lavage were found. CONCLUSIONS: There was a higher frequency of chronic colonization of P aeruginosa in the lower respiratory tract in patients with nasal polyps. Otherwise, nonsevere nasal polyposis was not an indicator of lower respiratory tract morbidity in CF patients.
UI - 11806965
AU - Zammit-Maempel I; Hide IG; Hill J
TI - Case of the month. A hearing problem with a difference.
SO - Br J Radiol 2002 Jan;75(889):85-6
AD - Department of Radiology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
UI - 11819912
AU - Crampette L
TI - [Nasal-paranasal sinus polyposis]
SO - Presse Med 2001 Dec 22-29;30(39-40 Pt 2):44-50
1. POLYPOSIS AND ALLERGY: Nasosinusal polyposis and allergy must be considered as two distinct conditions. 2. POLYPOSIS: Approximately 1% of the general population has nasosinusal polyposis, a condition strongly associated with asthma (about one-third of the patients with polyposis have asthma). Patients with nasosinusal should undergo a complete respiratory examination in order to search for asthma or an asthma equivalent. 3. EOSINOPHILS: Eosiophils play a crucial role in the inflammatory reaction, releasing almost all the known inflammatory mediators: cytokines, chemokines and growth factors. 4. EPITHELIAL CELL: The epithelial cell probably plays a very important role. 5. MEDICAL TREATMENT: Long-duration intranasal corticotherapy is the basis of drug treatment. Short courses of oral corticosteroids may be useful during acute episodes in inflammation. The exact effect of oral corticosterid is not clearly elucidated but it is known that non-steroidal antiinflammatory drugs (NSAID) are contraindicated in polyposis. 6. SURGICAL TREATMENT: Surgery is reserved for medical failures or for patients with a contraindication for drug therapy. Endonasal ethmoidectomy is the basis treatment. 7. PERSPECTIVES: Better understanding of the underlying pathophysiology and the probable genetic component will determine future treatments. Perspectives include antiinflammatory drugs currently reserved for other conditions (antileucotriene, antiTNFa, IL-18) and elaboration of new antiinflammatory drugs.
UI - 11843557
AU - Chung J; Park ST; Jang J
TI - Fine needle aspiration cytology of metastatic olfactory neuroblastoma: a case report.
SO - Acta Cytol 2002 Jan-Feb;46(1):40-5
AD - Department of Diagnostic Pathology, Asan Kangnung Hospital, KangNungSi, South Korea. firstname.lastname@example.org
BACKGROUND: Olfactory neuroblastoma (ONB) is an uncommon tumor, presenting as a polypoid mass arising from the upper nasal cavity. This tumor has been seldom diagnosed by direct fine needle aspiration (FNA). CASE: Metastatic ONB was diagnosed by FNA. The patient was a 40-year-old female with a polypoid mass in the nasal cavity and ipsilateral cervical lymphadenopathy. The punch biopsy of the nasal tumor revealed a smudged small round cell neoplasm with neuroendocrine differentiation, consistent with ONB. In FNA smears from the cervical lymph node, there were well-preserved, small, monotonous cells with hyperchromatic nuclei, fibrillary cytoplasm and indistinct cell borders. Also noteworthy were occasional pseudorosettes as well as rare true rosettes. By immunocytochemistry, tumor cells were positive for cytokeratin, chromogranin and synaptophysin. CONCLUSION: ONB, like adrenal neuroblastoma, shows distinctive cytologic features, including a rosette or pseudorosette and fibrillary network. FNA can accurately demonstrate these characteristic findings, and in some cases it may be a better diagnostic modality than incisional biopsy.
UI - 11802479
AU - Benoliel P
TI - [Treatment of sino-nasal polyposis by Candida albicans immunotherapy: apropos of 4 cases]
SO - Allerg Immunol (Paris) 2001 Dec;33(10):388-94
The NSP is an inflammatory chronic disease of the mucous of nose and sinuses. None etiological treatment is known up to now. The aim of this study is to consider a model of autoallergy as etiology for NSP proven by specific immunotherapy (STI) to Candida albicans (CA). METHODS: Four NSP treated by SIT to Candida albicans are reported. The patients are treated either by subcutaneous injections or sublingual drops. The frequency is one injection per week or a few drops per day (absorbed extract on calcium phosphate or aqueous Stallergenes). RESULTS: The cumulated doses varies from 465 Index of Concentration (IC) to 117500 IC on a period of 3 to 4 years. The results are evaluated according the rhino-sinusal semeiology, the intensity of symptoms, and the stage of polyposis. The SIT is also active on both a late and an immediate components for the symptoms, and the cutaneous tests. The results are significant 60% to 80% of improvement. The viral or bacterial infections reactivate both types of hypersensitivity and they are prevented by SIT. The nasal hyperactivity observed as a more advanced non specific stage of the PNS is also improved by ITS. In two of the clinical cases, the pollenogenic seasonal obstruction is added to the nasal perennial obstruction in a sharp manner. The pollenogenic allergy is also improved after SIT to CA without any other associated SIT. CONCLUSION: The model of autoallergy already proven as etiology for atopic dermatitis can serve as a base of exploration of PNS. That is showing the presence of IgE antibody corresponding to intracellular proteinic autoallergens having an analogy to environment allergens. The allergy to Candida albicans can thus be considered as an etiology of the PNS.
UI - 11738698
AU - Wong BY; Hui Y; Lam KY; Wei WI
TI - Neurothekeoma of the paranasal sinuses in a 3-year-old boy.
SO - Int J Pediatr Otorhinolaryngol 2002 Jan 11;62(1):69-73
AD - Department of Otorhinolaryngology, Division of Otorhinolaryngology Head and Neck Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, SAR, Hong Kong, People's Republic of China. email@example.com
Neurothekeoma is a benign soft tissue tumor commonly located on the skin. In this report, a 3-year-old boy presented with restricted right eye movement and decrease in visual acuity. The patient was found to have a 6-cm neurothekeoma involving the maxillary and ethmoid sinuses. To our knowledge, this is the first reported case of neurothekeoma with involvement of the maxillary and ethmoid sinuses. This uncommon lesion should be considered as the differential diagnosis of pediatric soft tissue tumors in the head and neck region.
UI - 11843456
AU - Runte C; Runte B; Dirksen D; Bollmann F; Micke O; Schafer U; Willich N
TI - A pivoting appliance for intracavitary brachytherapy in patients with reduced mouth opening.
SO - Int J Prosthodont 2001 Mar-Apr;14(2):178-82
AD - Department of Prosthodontics, University of Muenster, Germany. firstname.lastname@example.org
PURPOSE: The risks of radiotherapy to normal tissues are well known. In many cases, a tumor patient suffering a relapse cannot undergo radiotherapy a second time. One exception may be the local application of brachytherapy. Afterloading devices allow the position of radiating materials near the site for treatment exactly according to three-dimensional treatment planning. This report shows the technical procedure for the fabrication of an intracavitary afterloading radiation device. MATERIALS AND METHODS: A 48-year-old woman who had received neutron radiotherapy and tumor surgery for adenoid cystic carcinoma had to be treated for relapse. The mouth opening was limited to 15 mm. The mixing tip of a silicone impression system was used as an axis for a pivoting appliance. RESULTS: Two years after reradiation, the patient was free of relapse symptoms, although an increased limitation of mouth opening was recorded. CONCLUSION: Even if the mouth opening is severely limited after tumor surgery and/or radiation, intracavitary brachytherapy still can be performed in edentulous patients using a pivoting device.
UI - 11765447
AU - Poludniewska B; Rogowski M; Soroczynska J
TI - [Preliminary assessment of the role of IL-5 in the pathogenesis of nasal polyps]
SO - Otolaryngol Pol 2001;55(3):303-5
AD - Klinika Otolaryngologii Akademii Medycznej w Bialymstoku.
Preliminary results of IL-5 levels in homogenates derived from nasal polyps tissue are presented. The IL-5 concentration was assessed by immunoenzymatic method (ELISA, R&D, Systems Minneapolis). 26 patients at age 21-60 years were examined. IL-5 cevels were higher in polips with allergic and were examined. IL-5 levels were higher in polips with allergic and aspirin idiocracy background compared with inflammatory polips. In addition, IL-5 levels were increased in recurrent polips.
UI - 11815930
AU - Akmansu H; Eryilmaz A; Dagli M; Korkmaz H
TI - Endoscopic removal of paranasal sinus osteoma: a case report.
SO - J Oral Maxillofac Surg 2002 Feb;60(2):230-2
AD - Department of Otolaryngology and Head and Neck Surgery, Numune Hospital, Ankara, Turkey.
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