Perivascular Epitheloid Cell Tumor (PEComa) of the Neck.

Perivascular epitheloid cell tumors (PEComas) are a family of neoplasms with distinctive perivascular epitheloid cells. 36 year old female patient admitted to our clinic with a mass on neck. Biopsy was reported as PEComa. PEComas are very rare, especially in neck region. Here, we present the second case in literature.

Chronic Rhinosinusitis in Patients with Primary Immunodeficiency.

INTRODUCTION: Primary immunodeficiencies are a heterogeneous group of diseases associated with an increased incidence of infections, autoimmunity, autoinflammatory diseases, allergies, and cancer. Rhinosinusitis is one of the most common infections in these patients. In our study, we aimed to determine the presence of chronic rhinosinusitis in our patients with primary immunodeficiency and to investigate the etiology of chronic rhinosinusitis. METHODS: Forty-four patients (age range: 4-26 years) diagnosed with primary immunodeficiency were enrolled in our study. Patients were interviewed about the symptoms of chronic rhinosinusitis, and nasal endoscopic examinations were performed prospectively. The results of laboratory tests, medications, skin allergy tests, and the patients' lung computed tomography were retrospectively recorded from patient files. RESULTS: The distribution of patients' diagnoses included 38.6% (n = 17) primary antibody deficiencies, 6.6% (n = 3) combined immunodeficiencies, 27.3% (n = 12) combined immunodeficiencies with syndromic features, 6.8% (n = 3) phagocytic disorders, and 20.5% (n = 9) immune dysregulation disorders. There was no significant difference in the frequency of chronic rhinosinusitis among the different immunodeficiency groups. There were no significant differences between chronic rhinosinusitis and conditions such as atopy, hypogammaglobulinemia, and treatments with immunoglobulin and/or azithromycin. The incidence of chronic rhinosinusitis was 77.8% (n = 7) in patients with a history of acute sinusitis and 20% (n = 7) in patients without a history of sinusitis, with a statistically significant difference between them (p = 0.002). CONCLUSION: Chronic rhinosinusitis is more common in patients with primary immunodeficiencies than in the normal population. For effective treatment, it is necessary to identify the factors that cause chronic rhinosinusitis. Further studies involving larger patient populations are needed to explain the mechanisms of chronic rhinosinusitis.

Delayed presentation of head and neck cancer patients during COVID-19 pandemic.

PURPOSE: Impact of COVID-19 pandemic on healthcare is huge. We intended to demonstrate how COVID-19 pandemic affected primary head and neck oncology patient's referral and admission to a tertiary center by comparing the retrospective patient data in March-September 2020 and the same period in 2019. METHODS: In this cross-sectional study, from March 15th, 2020 to September 15th, 2020, medical records of 61 patients (Group 1) diagnosed and scheduled for surgery for head and neck cancer in our tertiary care center were revised and compared with 64 head and neck cancer patients treated in the same institution in the same time period of the previous year (Group2). Surgical site, TNM stages, need for reconstruction with flap, time from first symptom occurrence to first admission to our institution, and time to surgery were noted. RESULTS: In Group 1, out of 56 patients, 26 were diagnosed with T1-2 tumor, while 30 had T3-4 tumor. In Group 2, 43 of 60 patients had T1-2 tumor, while only 17 of them were diagnosed with T3-4 tumor. The rate of T3-4 tumors had significantly increased in 2020 when compared to 2019 (p = 0.049). In oral cavity cancer patients, N stage was significantly increased in Group 1 when compared to Group 2 (p = 0.024). Need for reconstruction with regional or free flaps were significantly increased in oral cavity cancer patients (p = 0,022). The mean time from the beginning of the first symptom to the admission was 19.01 ± 4.6 weeks (ranging between 11 and 32 weeks) in Group 1, while it was 16.6 ± 5.9 weeks in Group 2 (ranging between 6 and18 weeks); with significant increase (p = 0,02). The time to surgery from first admission was 3.4 ± 2.5 and 2.9 ± 1.2 weeks in Group 1 and 2, respectively, with no statistically significant difference (p = 0.06). CONCLUSION: The COVID-19 pandemic has caused delay in the diagnosis and treatment of many diseases as such in head and neck cancers. Admission with advanced stage disease and the need for more complex reconstructive procedures were increased. During the pandemic, the management of other diseases that cause mortality and morbidity should not be neglected and priorities should be determined.

Evaluation of Olfactory Function With Objective Tests in COVID-19-Positive Patients: A Cross-Sectional Study.

OBJECTIVE: Olfactory dysfunction is relatively high in coronavirus disease 2019 (COVID-19) patients. The aim of this study is to investigate the incidence of olfactory disorder objectively in patients with laboratory-confirmed COVID-19 infection. MATERIAL AND METHOD: The study included 31 healthy controls and 59 COVID-19 patients who were diagnosed and treated in the COVID departments in a tertiary hospital. The patients with corona virus infection were screened by a questionnaire and were classified into 2 groups as either group 2 (patients without self-reported smell loss) or group 3 (patients with self-reported smell loss). Age and gender matched healthy controls who do not have chronic nasal condition or nasal surgery history comprised the control group (group 1). All of the patients and subjects in the control group were tested by the Sniffin' Sticks test. All of the answers and scores were recorded, and the comparisons were made. RESULTS: The rate of self-reported smell and taste loss in all COVID-19 patients in this study was 52.5% and 42%, respectively. There was a significant difference in threshold, discrimination, identification, and Threshold, Discrimination, Identification (TDI) scores between groups 1 and 2. When the comparisons between group 1 and 3 were made, again threshold, discrimination, identification, and TDI scores were significantly different. The comparison between groups 2 and 3 demonstrated a significant difference in discrimination, identification, and TDI scores, but threshold score was not different statistically. With questionnaire, the rate of olfactory dysfunction in COVID-19 patients was 52.5%, but with objective test, the rate was calculated as 83%. CONCLUSION: Olfactory and gustatory dysfunctions are common in COVID-19 patients. According to findings with the objective test method in this study, smell disorder in COVID-19 patients was much higher than those detected by questionnaires.