Malignant ectomesenchymoma of the paranasal sinuses with proptosis.

PROBLEM: A 36-year-old woman presented with a feeling of pressure in the right orbit and proptosis of the right eye after a "common cold". METHODOLOGY: Computed tomography (CT) of the maxillofacial region revealed, and endoscopy confirmed, a mass in the right ethmoid sinus, eroding the lamina papyracea and extending into the orbit. Pathology of multiple biopsies revealed a nasal neoplasm composed of neuroectodermal and mesenchymal neoplastic elements, suggestive of a malignant ectomesenchymoma (MEM). Magnetic resonance imaging was used for MEM staging. Computed tomography of the chest and abdomen show no evidence of distant metastases. RESULTS: Due to the intracranial and intraorbital extension of the tumour, radical surgery was not an option. Appropriate chemotherapy (6 cycles of vincristine/ifosfamide/adriamycin and 2 cycles of vincristine/ifosfamide/cisplatin) and intensity-modulated radiation therapy were administered. CONCLUSION: Twenty-eight months after treatment, there was no evidence of residual or metastatic disease.

Sensitization to common aeroallergens in patients at an outpatient ENT clinic.

OBJECTIVES: The epidemiology of specific sensitization to inhalant allergens remains unknown in patients at tertiary rhinology clinics. We used skin prick testing (SPT) to assess sensitization to major aeroallergens in order to evaluate the prevalence of specific rhinologic diseases, the frequency of polysensitization and the relationship between nasal symptoms, nasal endoscopy parameters, diagnosis and sensitization. METHODS: A retrospective review of medical records was conducted at the ENT Department of the Catholic University Hospital in Leuven, Belgium. The study analyzed the medical data of patients with rhinologic symptoms suspected of having allergies. RESULTS: The study included 1326 patients with a mean age of 35 +/- 18 years (range: 3-88 years); 52.8% were males. Rhinitis without nasal abnormalities (42.1%), chronic rhinosinusitis without nasal polyps (16.5%) and nasal abnormalities (16.1%) were the most prevalent findings. About 31.6% of patients were sensitive to at least one allergen, and the most common aeroallergens were dermatophagoides pteronyssinus (62.1%) and grass pollen (53.2%). Polysensitization was found in 54.2%. The most prevalent clinical symptoms in allergic rhinitis patients were nasal obstruction, clear/watery nasal discharge, sneezing, postnasal drip and headache. Clear nasal discharge, sneezing, and itchy nose and eyes (p < 0.05 for all) were significantly higher in sensitized patients. In contrast, postnasal drip, headache and purulent nasal discharge were also observed in non-sensitized patients (p < 0.05 for all). CONCLUSIONS: At a rhinology clinic at a university ENT clinic, 31.6% of the patients had positive SPT results, mainly to house dust mites and grass pollen. Among sensitized patients, 54.2% were polysensitized.