Cases reported "Nose Neoplasms"

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1/30. Lymphoepithelioma-like carcinoma of the skin with apparent origin in the epidermis--a pattern or an entity? A case report.

    BACKGROUND: Lymphoepithelioma-like carcinoma (LELC) is prototypically represented by "undifferentiated" nasopharyngeal carcinoma, but it has also been described in many other anatomic locations, including the skin. In the last of these sites, primary LELC has been assumed in the past to show dermal adnexal differentiation. methods: The authors present a case wherein LELC of the skin (LELCS) instead appeared to be a morphologic manifestation of squamous carcinoma of the skin surface, as supported by the results of immunohistology and in situ hybridization. RESULTS: Like other examples of LELCS, it showed no evidence of integration of the Epstein-Barr viral genome, and its behavior was indolent. CONCLUSIONS: The heterogeneous nature of LELC as seen in different body sites is reviewed in this report, resulting in the conclusion that this tumor probably represents a morphologic pattern rather than a distinct clinicopathologic entity.
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2/30. Endoscopically assisted anterior cranial skull base resection of sinonasal tumors.

    The traditional approach to sinonasal tumors involving the base of skull has been the anterior craniofacial resection. Endoscopic techniques have created the potential to approach the intranasal aspect of skull base lesions without external incisions and still develop an en bloc resection when removed. We report our initial experience with skull base neoplasms in which the otolaryngic portion of the standard resection was accomplished instead through an endoscopic approach. The nature of lesions favorable for this approach and associated technical issues are discussed. Although we do not consider this approach a replacement for the traditional anterior craniofacial resection, it is an important adjunct in the skull base surgeon's armamentarium.
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3/30. Angiectatic nasal polyps that clinically simulate a malignant process: report of 2 cases and review of the literature.

    BACKGROUND: Approximately 5% of inflammatory or allergic sinonasal polyps develop extensive vascular proliferation and ectasia with deposition of pseudoamyloid. These so-called angiectatic nasal polyps (ANPs) can grow rapidly and exhibit an aggressive clinical behavior that could simulate malignancy preoperatively. OBJECTIVE: To systematically address the differential histologic diagnosis of ANPs. methods: We evaluated by light microscopy, immunohistochemistry, and electron microscopy biopsy and resection specimens from 2 large ANPs (8 and 10 cm in diameter) that presented in 2 adult men with life-threatening epistaxis and facial deformity, respectively. RESULTS: The tumors were firm, lobulated, and covered by smooth, partially ulcerated mucosa. Histologically, clusters of dilated, thin-walled blood vessels embedded in pools of congo red-negative eosinophilic material, associated with patchy necrosis and atypical stromal spindle cells, were seen. Electron microscopy and immunohistochemistry (CD34, factor viii) confirmed the endothelial nature of the cells lining the spaces, whereas the atypical stromal cells were classified as myofibroblasts. CONCLUSIONS: These 2 cases represent extreme examples of ANPs that clinically simulate a malignant process. awareness of the histological features of ANPs should prevent confusion of such lesions with other vascular or spindle cell lesions of the nasopharynx that would require different treatment and carry a different prognosis.
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4/30. Reconstruction of the nasal tip using a nasalis myocutaneous flap.

    Reconstruction of nasal tip defects is a technical and aesthetic challenge for dermatological surgeons, due to the limited reservoir of available skin and its thick, inflexible nature. The myocutaneous flap described in this paper, using the vascular pedicle of the transverse nasalis muscle, is an excellent option for repair of defects of the nasal tip. It provides a cosmetically superior result to skin grafting, particularly in noses of 'sebaceous' quality, by providing similar local skin. The flap maintains normal nasal tip contour and, being an axial pattern flap, its blood supply is reliable.
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5/30. Nasal glioma.

    A case of nasal glioma is presented along with a brief review of the artiology, structure and diagnostic possibilities and published in earlier surveys. Considering the extremely benign nature of this type of tumour, we are of the opinion that the surgical measures may be relatively conservative and that mutilating, or grossly disfiguring, procedures should be avoided.
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6/30. Nasal glioma or nasal glial heterotopia? Morphological, immunohistochemical and ultrastructural study of two cases.

    The term nasal glioma has been used to describe a congenital benign tumor of the nasal region containing neural tissue. The nature of these lesions remains open to controversy, because of the different locations of the heterotopic neural tissue involved, the deficient development of the bony structures and the persistence or not of the structural relations with the central nervous system. More recent terms define these lesions as ectopic nervous tissue. A clinical, morphological, ultrastructural and immunohistochemical study is made of two cases of nasal glioma, one associated with agenesis of the corpus callosum. In this case, the mother had been treated with clomiphene. In such cases, morphological and immunohistochemical findings support that "nasal glioma" remain valid as a descriptive term defining a congenital benign tumor composed of heterotopic neural tissue within the nasal region and covered by skin, that may recur following incomplete surgical resection.
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7/30. myxoma of the nasal cavity and paranasal sinuses: report of a case.

    Myxomas are benign connective tissue tumors composed of stellate and spindle-shaped cells with benign-appearing nuclei lying in a myxoid stroma. They are usually found in the heart, soft tissues, and bones. Myxomas of the nasal cavity and paranasal sinuses are very rare. They are benign but of a locally invasive nature. Recurrent rate is high because of the difficulty to excise them completely. This article presents a case of myxoma of the nasal cavity and paranasal sinuses that extensively invaded the brain and orbits causing blindness. After three resections, also with a transbasal craniotomy in the second operation, the patient remains free from the disease.
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8/30. A rare location of bilateral inverted papilloma of the nose and paranasal sinuses.

    Inverted papilloma is a rare benign sinonasal tumour, characterized by a potentially invasive nature. The lateral nasal wall represents the most common site of origin, whereas paranasal sinuses are involved by extension quite frequently. In contrast, primary sinus inverted papillomas have rarely been reported. Although the midfacial degloving approach has historically been the procedure of choice, recent technological advances have rendered endoscopic sinus surgery a safe procedure with equivalent success rates and low probability of papilloma recurrence. We present a rare case of bilateral inverted papilloma arising from the sphenoid septum and extending towards both the sphenoid and posterior ethmoid sinuses and the posterior section of both nasal cavities, while it slenderizes the sella turcica by compression and elevates the pituitary gland. The bilateral inverted papilloma was successfully removed with a transnasal endoscopic procedure. There is no evidence of recurrence for a follow up period of 1.5 years postoperatively. We conclude that it is a rare entity, which can be treated successfully with endoscopic sinus surgery in the hands of an experienced otorhinolaryngologist.
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9/30. Pleomorphic adenoma originated from the inferior nasal turbinate.

    Although pleomorphic adenoma is the most common benign neoplasm of the salivary glands, it has also been reported to be present in the neck, ear, mediastinum, external nose and nasal cavity. Intranasal localization of this lesion is very rare and mainly originates from the nasal septum. From wherever the lesion originates, the main treatment modality should be surgical. We presented a very rare case of intranasal pleomorphic adenoma originated from the inferior nasal turbinate. Due to the expansile nature of the lesion, a midfacial degloving approach was preferred.
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10/30. Nasal NK/T-cell lymphoma causing diagnostic difficulties.

    We present history, clinical presentation and anatomo-pathologic findings of a 24-year-old female patient with a nasal NK/T-cell lymphoma. This rare tumor is characterized by its angiocentric and angiodestructive growth, which results in extensive tumor necrosis. At the first encounter this tumor necrosis made it difficult to identify the nature of the tumor cells. However, this necrosis is a key feature: it is the result of the capacity of neoplastic NK/T-cells to invade vessels. The T-cell character of the neoplastic lymphoid has been shown by immunohistochemitry.
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