Olfactory neuroblastoma (esthesioneuroblastoma): towards minimally invasive surgery and multi-modality treatment strategies - an updated critical review of the current literature.

Olfactory neuroblastoma (esthesioneuroblastoma) was first described by Berger and Luc in 1924. It is considered to be an uncommon malignancy of the nasal cavity. The tumor arises from the specialized sensory epithelial olfactory cells, normally situated at the upper part of the nasal cavity, including the superior nasal concha, the roof of the nose and the cribriform plate. The imaging modalities of choice are computed tomography (CT) and magnetic resonance imaging (MRI). Combination of surgery and radiotherapy (either conventional radiotherapy or stereotactic radiosurgery), with or without chemotherapy is considered to be the standard of care for primary site disease by the majority of researchers. Combined transfacial and neurosurgical conventional approaches are also adopted in many reported cases, mainly due to the endocranial extension and the close anatomic relationship of esthesioneuroblastomas with the ethmoid roof and cribriform plate. Recent literature supports that endoscopic resection correlates with similar oncologic control rates compared with conventional open surgery, provided that basic oncologic surgical principles with clearance of margins and intradural dissection (when required) are completely maintained.

Adhesion molecules in cancer of the head and neck: role of dysadherin.

Dysadherin is a recently discovered cancer-related cell membrane glycoprotein that has an important role in tumor progression and metastasis. We are focusing on the role of dysadherin in E-cadherin downregulation, the different expression patterns of the molecule in cancer of the head and neck and its potential role as a molecular target for future applications in diagnosis, prognosis, and management of the disease.

Laryngeal paragangliomas - controversies in diagnosis and management.

Paragangliomas of the larynx are rare neuroendocrine tumors with difficulties in diagnosis and management. A review of the literature was carried out, using Medline and other available databases. Electronic links and related books were also included. The most reliable diagnostic imaging procedures are MRI, CT scan, and octreotide scintigraphy. Complete surgical excision with the maximal possible preservation of the laryngeal function is the treatment of choice. Many different surgical techniques have been reported but open surgical procedures seem to provide better results with lower recurrence rates, although endoscopic approaches and laser surgery have also been used with variable results. The use of long-acting depot octreotide has been used for the relief of symptoms and stabilization of the disease, especially in inoperable lesions with positive initial octreotide scintigraphy imaging. Detailed preoperative assessment and treatment planning in individual basis are essential in the management of these tumors.

Lingual abscess in a psychiatric patient: a case report.

We present a 46-year-old psychiatric patient presenting with a lingual abscess. This paper covers the epidemiology, clinical features, diagnosis, and differential diagnosis with a view to assisting emergency physicians in the timely recognition and management of this rare but potentially life-threatening condition.

Nasopharyngeal cylindrical cell papilloma.

INTRODUCTION: Cylindrical cell papillomas are rare tumours which usually arise in the sinonasal region. CASE REPORT: We report a case of a nasopharyngeal cylindrical cell papilloma in a 56-year-old man who presented with a four-month history of right-sided hearing loss, otalgia, vertigo and tinnitus. Investigation revealed a soft, nodular lesion obstructing the pharyngeal opening of the right eustachian tube; this was treated by wide endoscopic excision. CONCLUSION: Cylindrical cell papilloma is a possible cause of eustachian tube obstruction in adults. Effective treatment of these lesions usually requires wide endoscopic excision, in order not to miss coexistent carcinoma.

Cochlear implantation following temporal bone fracture.

Patients with bilateral temporal bone fractures frequently suffer profound hearing loss. These patients may benefit from cochlear implantation. Displaced fracture lines and ossification of the cochlea might complicate insertion of the electrode array. In the present paper we present a case of a failed cochlear implantation due to ossification of the cochlea, followed by a successful one on the opposite side in a patient who sustained bilateral temporal bone fractures. Preoperative imaging may identify these factors, help guide the appropriate surgical approach and choose which side to implant. We aim to highlight the necessity of imaging and discuss the reliability of computed tomography (CT) scanning in predicting cochlear patency in cases of temporal bone fracture. Possible management options in the case of complex cochlear implantation are also described.

Neuroendocrine carcinoma arising from the septum. A very rare nasal tumour.

The case is presented of a 73-year-old male with a history of right-sided nasal obstruction, hyponasal speech and three episodes of recurrent epistaxis. On examination, there was a tumour in the right nasal cavity. Computed tomography showed a mass in the right nasal cavity extending to the right maxillary sinus, ethmoidal cells and right sphenoid sinus. The patient underwent a functional endoscopic removal of the tumour. Biopsy revealed a small cell neuroendocrine carcinoma. This is an extremely rare tumour of the nasal cavity and sinuses. Because of the aggressive behaviour of this tumour, he was also treated with combined chemotherapy and radiation. Ten months later, he remains free of disease.

Myoepithelial carcinoma of the retromolar area in a young female. A rare case report.

We present a case of a 34-year-old woman with myoepithelial carcinoma of the retromolar area. Myoepithilial carcinoma is a rare tumor of small salivary glands most usually located in the parotid gland. The major differential diagnosis of myoepithelioma is from pleomorphic adenoma. Little is known about the clinical and biological behavior and the prognosis of myoepithelial carcinoma and there is no consensus for its treatment. It is considered a low-grade malignancy; it sometimes shows aggressive behavior and may locally recur. Our patient was treated successfully with wide-local resection and remained free of disease for 6 months.