Acinic Cell Carcinoma of the Nasal Lateral Wall.

Primary acinic cell carcinoma arising in the nose is exceptionally rare. In this report, we present a unique case of an acinic cell carcinoma of the nasal lateral wall, and it is only the second such case to be reported. We also engage in a systematic review of all 18 cases of acinic cell carcinoma of the nose reported in the literature in English so far.

Pretreatment Blood Markers in the Prediction of Occult Neck Metastasis: A 10-Year Retrospective Study.

Introduction The purpose of this study was to clarify the role of inflammatory blood markers in the management of early-stage (T1-T2) oral squamous cell carcinoma (OSCC) of the tongue in patients with a clinically negative neck.  Materials and methods We undertook a retrospective chart review of 102 patients with early-stage OSCC of the tongue, subjected to tumor resection and elective neck dissection. Based on postsurgical histopathological examination results, we divided our cohort into pN+ and pN0 groups. Afterwards, we analyzed the role of pretreatment inflammatory blood markers in predicting occult neck metastasis. We also evaluated neutrophil-lymphocyte ratio (NLR) association with the depth of invasion (DOI) of the primary tumor. Results We found a significant association of NLR (p=0.001) and monocyte-lymphocyte ratio (p=0.011) with neck status on univariate analysis. Multivariate analysis showed that only NLR (p=0.02) was an independent risk factor for occult metastasis among inflammatory blood markers. Receiver Operating Characteristic curve analysis and Younden's Index determined the NLR value of 2.96 as the most adequate cut-off value for neck status prediction. NLR values of pretreatment workup also had a significant association with the DOI of the primary tumor (p=0.018). Conclusion Our study supports the role of pretreatment NLR in predicting occult neck metastasis in early-stage OSCC of the tongue. It also sheds some light over the potential of NLR as a predictor of the primary tumor's DOI.

Parapharyngeal schwannoma-a challenging case report.

Parapharyngeal space primary neoplasias are infrequent findings in clinics, and schwannoma derived from a peripheral nerve is even rarer in this anatomic area [1]. The presented case is a patient who was referred to our department with a 3 months progressive soft palate enlargement without related symptoms. The challenge, in these cases, due to the anatomic complex area, is to catch a suitable approach to remove the tumor, according to dimension and surrounding structures. Prognosis and follow-up will depend on histopathologic evaluation.

Maxillary mesenchymal chondrosarcoma leading to a diagnosis of Li-Fraumeni syndrome.

Mesenchymal chondrosarcoma (MCS) is a rare histological variant of chondrosarcoma, with aggressive behaviour. Due to the unique nature of this disease, management strategies are not well established. Li-Fraumeni syndrome (LFS) is a rare cancer predisposition syndrome with a wide tumour spectrum, associated with TP53 germline mutations. We report a case of MCS of the maxilla, treated with surgical excision and adjuvant chemotherapy, in a patient with a past medical history of choroid plexus papilloma and a family history of early age first-degree cervical uterine cancer, that led to the clinical suspicion of a cancer predisposition syndrome and the subsequent diagnosis of LFS. This is the first MCS described in a LFS case. It demonstrates that adjuvant chemotherapy should be considered, in conjunction with surgical excision, in MCS and that cancer predisposition syndromes should be suspected in patients with multiple neoplasms and a strong family history of cancer.

Mandibular meningioma-a rare case report of a second extracranial meningioma and a systematic literature review.

Meningiomas are benign tumours common in the central nervous system. Primary extracranial meningiomas in the jaws are extremely rare. We performed a systematic review of all the primary extracranial meningioma arising in the jawbones reported in the English-language literature including indexed and non-indexed journals and we report a unique case in our hospital of a man with two primary extracranial meningiomas, the first frontal intradiploic and 16 years later, a second located in the mandible. We found 14 cases with primary jaws meningioma and we report another one. A mandibular predominance was observed with only four cases in the maxilla. Most of them occurred in women, with a mean age of 35.9 years. It is the first published case of a patient with two primary extracranial meningiomas one of them in the mandible, which the gender, age and laterality of the lesion are less frequent.

Exame digitálico da papila e fibras nervosas retinianas / Digital examination of the optic disc and the retinal nerve fiber layer

Quando olhamos uma imagem oftalmológica, nós a vemos através do nosso aparelho visual. Quando esta mesma imagem é analisada pelo computador, ele utiliza parâmetros diferentes de avaliaçäo e o seu resultado gráfico revela uma outra face da imagem oculta à visäo convencional. O atual trabalho aplica praticamente estes conceitos e avalia digitalmente a papila e feixes de fibras nervosas retinians (RNFL). A importância do tema, a lesäo das células ganglionares procede o aparecimento de defeitos na campimetria. Sinteticamente utilizamos o seguinte material: CR5-45NM Canon - retinal camera non-mydriatic; video câ,mera Sony 3CCD; placa digital de captura MIRO DC20 (captura a imagem do flash); software para estudo de imagens: N.I.H. (National Institute of Health U.S.A.), utilizado para a