1/8. Common head and neck manifestations of AIDS.head and neck manifestations of acquired immunodeficiency syndrome (AIDS) can involve the skin, ear, upper aerodigestive tract, and neck. Several head and neck manifestations of AIDS may be the only initial sign of this disease process and therefore primary-care physicians and otolaryngologists must be able to recognize and understand the management of these lesions. Cystic enlargement of the parotid gland and Kaposi's sarcoma are increasingly being encountered in the head and neck exam of hiv-infected patients. An example of each of these disease processes is presented with full discussion about the various treatment methods.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/8. rhinophyma and coexisting occult skin cancers.BACKGROUND: Although coexistent tumors have been reported in patients with rhinophyma, few reports have described the coexistence of rhinophyma and an occult infiltrating squamous cell carcinoma (SCC). OBJECTIVE: Preoperatively and during rhinophymaplasty, recognition of subtle changes can suggest an underlying malignancy. methods: A large infiltrating SCC was noted during electrosurgical rhinophymaplasty. Mohs micrographic surgery was performed to clear the tumor. RESULTS: The patient was tumor-free with no evidence of recurrence at 1-year follow-up. CONCLUSION: In the evaluation of changing rhinophyma or subtle changes in tissue noted during rhinophymaplasty, physicians must consider the possibility of an underlying malignancy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/8. Management pitfalls in the use of embolization for the treatment of severe epistaxis.Angiographic embolization for the treatment of severe recurrent epistaxis was added to the traditional treatment options--nasal packing, cauterization, and surgical vessel ligation--in 1974. Since then, clinical experience has shown that this procedure is safe and effective. When epistaxis cannot be controlled with cautery, nasal packing is the most common next step. As such, it is often performed by emergency physicians and other clinicians who are not otolaryngologists. We report two cases in which intranasal neoplasms were obscured as a result of a significant distortion of the normal anatomy. This distortion was secondary to emergency-room treatment of severe epistaxis by repeated nasal packing followed by angiographic embolization. Pre-embolization angiographic studies and subsequent postembolization endoscopic evaluations did not reveal the presence of the occult neoplasms because of the presence of inflammation and edema after treatment. Clinicians should be aware that nasal packing and embolization can obscure the underlying source of epistaxis, and follow-up radiologic studies and endoscopic evaluations are essential to avoid delays in diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/8. A rare case of mucoepidermoid carcinoma of the nasal cavity.Mucoepidermoid carcinoma of the nasal cavity is rare. We report the case of a 57-year-old man who was evaluated for a rapidly enlarging subcutaneous mass on the nasal bridge. The tumor was diagnosed as a mucoepidermoid carcinoma. The patient underwent extensive surgical resection and postoperative radiotherapy, but 5 months later he required orbital exenteration for persistent disease. Despite these radical measures, the patient died with persistent disease 9 months following the initial evaluation. The aggressive behavior of this tumor highlights the need for physicians to be aware of the differential diagnosis, symptoms, and signs of neoplasms that originate in the nasal cavity so that prompt treatment can be instituted.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/8. fibrosarcoma of the nose and the paranasal sinuses.We report a case of fibrosarcoma of the nose and paranasal sinuses and give a brief review of the literature. fibrosarcoma of the nose and paranasal sinuses is uncommon, and few cases have been reported to date. Previously these tumors may have been overdiagnosed secondary to inadequate diagnostic procedures. Because histologic diagnosis is difficult, these tumors have been confused with other lesions of the head and neck. Thus, the improvement in diagnostic procedures has significantly reduced the reported incidence of fibrosarcoma. Because histologic diagnosis is difficult, this tumor has often been confused with other lesions of the head and neck. To ensure proper handling of the tissue, the pathologist should be informed if fibrosarcoma is suspected. It may be necessary to use electron microscopy or staining techniques such as immunoperoxidase stains to distinguish fibrosarcoma from other lesions. Unfortunately, the early signs and symptoms of the tumor are vague and sometimes misleading. Thus, at the patient's initial visit, it is important that the physician consider the possibility of fibrosarcoma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/8. Esthesioneuroblastoma: diagnosis and treatment.Esthesioneuroblastoma is a nasal tumor which arises from cells of neural crest origin. It is a difficult tumor to diagnose clinically and histopathologically. First described in 1924, approximately 160 cases have been reported with over 125 of these in the last 15 years. This reflects an increased awareness of the tumor by physicians rather than an icreased incidence. In the past 17 years, 12 cases of esthesioneuroblastoma have been treated at the Department of otolaryngology and Maxillofacial Surgery of the University of virginia Medical Center. Reviewing these cases and the literature leads us to make the following recommendations for diagnosis and treatment: The diagnosis of esthesioneuroblastoma can be made by 1) the clinician who suspects it in any patient with a nasal mass causing unilateral obstruction; 2) the finding of plexiform intercellular fibrils by light microscopy (rosettes and pseudorosettes are not as common as reported); 3) the finding of secretory granules and neurites by electron microscopy of the highly undifferentiated tumors; and 4) formaldehyde-fume-induced fluorescence. Combined therapy with preoperative irradiation followed by craniofacial resection of the tumor to include the cribriform plate is recommended. This treatment should result in a five-year survival in excess of 50% of patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/8. A malignant nasal polyp. A clinically surprising plasmacytoma.In conclusion, this is a study of a 52-year-old white male who had the removal of a benign appearing nasal polyp with the surprising diagnosis of extramedullary plasmacytoma. The clinical course has been completely benign since surgery for over two years. This should alert physicians to the possibility that benign appearing polyps, on rare occasion, can be malignant, and particularly those polyps occurring on the septum should be carefully investigated. It happened that this patient had a plasmacytoma, and a search for the presence of multiple myeloma is warranted.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/8. Olfactory neuroblastoma (esthesioneuroblastoma): appearance on fine-needle aspiration: report of a case.Small round-cell tumors can arise from several anatomic sites in children and adults, and their primary diagnosis and clinical course often present challenges to physicians. We present a case of a rare adult-onset round-cell tumor, esthesioneuroblastoma, of nasal epithelial origin, which spread into the brain and subsequently to cervical lymph nodes. The report describes how fine-needle aspiration cytology identified the metastatic spread and contributed to its clinical management. The use of ancillary procedures in differential diagnosis of small round-cell tumors is reviewed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |