Sinonasal teratocarcinosarcoma in an adolescent male: A case report of an unusual neoplasm.

ABSTRACT: Sinonasal teratocarcinosarcoma (SNTCS) is an extremely rare and aggressive malignant tumor arising in the sinonasal tract, having a combined clinicopathological feature of teratoma and carcinosarcoma. It shows a male predominance and affects adults with an age range of 18-79 years and a mean age of 60 years. Here, we report a case of SNTCS in a 14-year-old male patient who presented with swelling over the upper right alveolus and pain in the right jaw for 2 months. The tumor was completely removed by right total maxillectomy with orbital mess reconstruction, and postoperative radiotherapy with chemotherapy was given. The follow-up of the patient for 2 years has shown evidence of recurrence and is now on palliative care.

Occupational safety threats among dental personnel and related risk factors.

Occupational diseases are primarily considered to be important health problems for individuals with occupations in heavy industry fields. Although dentists work in very clean and elegant offices, they are frequently exposed to various chemicals and high-intensity, sound-producing instruments, such as compressors and aerators. In our study, we aimed to investigate the risk for occupational hearing loss of dental personnel, by performing pure-tone audiometry in 40 dentists and comparing the results with those of healthy individuals. We also sampled the nasal mucosa to investigate the effects of occupational chemicals on the nasal mucosa of the dentists. The pure-tone audiometric thresholds at 5 different frequencies (1000, 2000, 4000, 6000, and 8000 Hz) and working time were evaluated as potential risk factors. The pure-tone audiometric results (as decibels) at each frequency and the median values for each side (right and left ears) were significantly higher for dentists than for the control group (P < 0.05). The pure-tone audiometric results did not significantly differ between the women and men in the study group (P > 0.05). The findings in the nasal mucosa (goblet cell hyperplasia, neutrophil/eosinophil/basophil distribution, metaplasia, dysplasia, premalignant or malignant cells) were similar in the study and control groups (P > 0.05). In conclusion, our study indicated that high-intensity, sound-producing equipment is an important occupational threat for dentists, whereas chemical agents have minimal hazardous effects.

Primary mucosal malignant melanoma of the head and neck.

Diagnosis, therapy, and prognosis of 40 patients with malignant melanoma of the mucous membranes, treated at one hospital from 1971 to 2006, were evaluated in a retrospective study. The survival rate was compared with that established by the German-Austrian-Swiss Study Group on Tumors of the Head and Neck (DÖSAK) for 121 cases. The cumulated 5-year survival rate amounting to 33% (DÖSAK study 35%) emphasizes the unfavorable prognosis of this tumor. Age, sex, or tumor location had no significant impact on a patient's survival. A modified surgical concept has been developed for the treatment of the primary tumor and its lymphatic drainage area to maintain a patient's quality of life. The entire tumor should be resected under histologic control ensuring a 5-mm safety margin of healthy tissue. Bone should only be resected if invaded by the tumor. Large resections of the upper or lower jaw should be avoided. A neck dissection does not improve the prognosis and should be performed only in the case of histologically confirmed invasion of lymph nodes.

Oral & maxillofacial manifestations in pediatric esthesioneuroblastoma-report of a case and review of literature.

Esthesioneuroblastoma (ENB) is a rare, malignant neoplasm arising from the olfactory epithelial cells, with only approximately 100 pediatric cases being reported in the literature since its original description in 1924. As a result of its origin high in the nasal cavity, most patients have non-specific symptoms, precluding early diagnosis and leading to the development of locally advanced disease that usually has been found to involve the orbital cavity, paranasal sinuses, and anterior cranial fossa in children. The purpose of this paper was to report a rare case of pediatric esthesioneuroblastoma diagnosed following the patient's dental complaints, wherein local invasion of the tumor into the maxillofacial region was noticed before its extension into other vital structures.

[Odontogenic myxoma of nasosinusal localization in a pediatric patient]. / Mixoma odontogénico de localización nasosinusal en un paciente pediátrico.

In the present study we report and discuss a case of odontogenic myxoma in a 13-month-old patient. Only two other reports have been published in the literature describing the occurrence of this type of tumor at an earlier age. Odontogenic myxoma is a benign mesenchymal neoplasm of the maxilla more common between the third and fourth decades of life. The case here reported is exceptional as it presents in an infant and, although some cases have been reported in the literature, this type of tumor is rare in early childhood. The most common locations include the ascending ramus and the angle of the jaw, although these tumors may also affect the upper maxilla, in which case they may involve the maxillary sinus. According to the review of the literature, these tumors show a recurrence rate of about 25%. Consequently, after the intraoperative clinical examination of the lesion and the assessment of the initial suspected diagnosis by means of intraoperative biopsy under general anesthesia, we carried out the resection of the tumor with wide margins at some points of the tumor location.

Organised hematoma mimicking sino-nasal malignancy in patients post-radiotherapy.

INTRODUCTION: Organised hematoma (OH) in the para-nasal sinus and nasal cavity is a rare, non-neoplastic, benign disease which can be locally aggressive. In clinical practice, OH is easily misdiagnosed as malignancy and over-treated. CASE SUMMARY: These patients with OH had a common history of malignant neoplasms post-radiotherapy, including two cases of nasopharyngeal carcinoma and one case of tonsil cancer with jaw osteosarcoma. All of the patients presented with symptoms of epistaxis and blood-tinged rhinorrhea. All of the patients received endoscopic endonasal surgery under navigation. DISCUSSION: All of the patients had a good recovery after surgery. There's no recurrence after follow-up at 6 months. We therefore hypothesised that radiotherapy could be a cause of the OH. Although OH is uncommon and difficult to diagnose, a history of malignancy and imaging features with appropriate treatment are key.

Primary sinonasal malignant melanoma with systemic metastasis in a non-gray horse.

A 27-y-old Anglo-Arabian gelding with bay coat color was presented with a swelling of the left maxillary region. Fenestration on the left maxilla revealed that the left maxillary sinus was filled with black-red tissue. A portion of the tissue was excised and diagnosed histologically as malignant melanoma. Genotyping of the STX17 gene for gray coat color revealed that the horse did not have the "gray" factor. The horse was euthanized ~3 mo after first presentation. During autopsy, a black-to-gray mass extended from the left nasal cavity to the surrounding paranasal sinus and invaded the hard palate, cribriform plate, and the cranial portion of the left olfactory bulb. Moreover, identical black nodules were present in lymph nodes from the mandible to the larynx, and in the spleen, liver, kidney, and adrenal glands. However, masses were not found in the skin, perineal region, or pelvic cavity. All of the black-to-gray nodules were malignant melanomas that were histologically identical to the initial biopsy; tumor emboli were also found in the kidney. Sinonasal mucosal melanoma is a rare disease in horses.

Clinical Characteristics and Surgical Outcomes of Sinonasal Lesions Associated With Tumor-Induced Osteomalacia.

OBJECTIVE: To investigate the clinical characteristics and surgical outcomes of sinonasal tumors associated with tumor-induced osteomalacia (TIO). STUDY DESIGN: Retrospective case series. SETTING: Single tertiary center. METHODS: We studied the clinical characteristics and surgical outcomes of 43 patients (22 male, 21 female) who had lesions in the nasal cavity and paranasal sinus associated with TIO and underwent surgery between August 2006 and November 2019. RESULTS: The mean ± SD duration between the onset of symptoms and surgery was 3.9 ± 2.6 years. The most common tumor site was the ethmoid sinus (76.7%), and the skull base was involved in 12 cases. Phosphaturic mesenchymal tumors were diagnosed in 41 patients, among whom there was 1 multifocal case. Another 2 cases involved odontogenic fibroma and hemangiofibroma, respectively. Serum phosphorus normalized in 39 cases within 4.4 ± 2.3 days, and serum fibroblastic growth factor 23 normalized within 1 day; clinical symptoms, however, gradually improved within several months after the first operation. There was no significant difference in the recovery rate between endoscopic and open surgery (P = 0.639). Two patients with recurrent cases and 2 with nonremission cases recovered after a sinonasal reoperation. The patient with a multifocal case recovered after the resection of the tumors in the ethmoid sinus and mandible. The overall recovery rate was 97.7%. CONCLUSION: Most sinonasal tumors associated with TIO are located in the ethmoid sinus, and the skull base is involved in some cases. Complete excision of the tumor leads to recovery, and endoscopic surgery could achieve recovery rates similar to those of open surgery.

Primary nasal-type natural killer/T-cell lymphoma of pterygopalatine fossa.

Primary tumors that originated from the pterygopalatine fossa are seen rarely. In this paper, the case of a 69-year-old woman who complained of a 2-month history of headache, extending to the left part of the face, teeth, and shoulder, is reported. She had undergone right total mastectomy and axillar dissection of a spindle cell-type metaplastic carcinoma of the breast 1 year ago. Computed tomographic and magnetic resonance images showed a mass originating from the pterygopalatine fossa. Pathologic examination of the biopsy specimen of the mass revealed a nasal-type extranodal natural killer/T-cell lymphoma with CD45 and intense CD56 staining. Our case shows that a nasal-type extranodal natural killer/T-cell lymphoma should be thought in mind for the differential diagnosis of primary tumors of the pterygopalatine fossa.

Hemangiopericytoma of meningo-fronto-naso-orbito-maxillary complex.

Hemangiopericytoma (HPC) is a rare vascular tumour and difficult to diagnose clinically. Incidence is reported in fourth to fifth decade of life.With female predominance, 3%-5% cases affect the oral cavity, sinus lining and meninges. The patient presented with 8×6 cm swelling on her face, evaluation reported it to be HPC. Bilateral maxillary artery embolisation, wide local excision of the lesion, preserving the left eye and its function, was done. No recurrence is reported at 1-year follow-up. Response of such lesions to radiotherapy is questionable; with no lymphadenopathy and adequate encapsulation, embolisation of feeder vessel followed by a wide local excision of the lesion seems to be a fairly good option of treatment.

Nasal neuroendocrine carcinoma in a free-living Japanese raccoon dog (Nyctereutes procyonoides viverrinus).

Neuroendocrine carcinoma was diagnosed in the left nasal cavity of a free-living Japanese raccoon dog (Nyctereutes procyonoides viverrinus). Microscopically, the tumour consisted of sheets of anaplastic cells separated by narrow zones of fibrovascular stroma. The neoplastic cells had varying numbers of cytoplasmic granules stained by the Grimelius method. Immunohistochemically, the neoplastic cells were variably labelled for cytokeratin AE1/AE3, vimentin, chromogranin A and S-100. Ultrastructurally, some of the neoplastic cells had cytoplasmic membrane-bound dense-core granules of approximate diameter 140-240nm. The tumour had infiltrated the cerebrum and metastasized to the pituitary gland, mandibular and pulmonary lymph nodes, lungs, thyroid gland and adrenal glands.

Nasal prosthesis supported with self-tapping implants with bioactive surface--a case report.

Nasal prosthesis using dental implants and magnetic abutments is a method of choice in replacement of missing hard and soft facial tissues. Nose form, coloration, and texture must be as indiscernible from the surrounding natural tissues as possible. Rehabilitation efforts can be successful only when patients can appear in public without fear of attracting unwanted attention. This case report evaluates on a step-by-step basis the materials and methods including implants insertion.

Nonkeratinizing squamous cell carcinoma: A rare case report with oral involvement.

Transitional cell carcinoma also known as nonkeratinizing carcinoma (NKCa) of sinonasal tract comprises 15%-20% of malignant sinonasal carcinoma. We are reporting the case of 48-year-old male with a history of tooth extraction. A computed tomography was done which showed opacity in the right nasal cavity. Incisional biopsy was taken which revealed NKCa (transitional type). Very few reported cases of this type of malignancy were found. A possible reason could be multiple synonyms such as cylindrical cell carcinoma, Schneiderian carcinoma, and transitional cell carcinoma.

[Osteoblastoma of the middle nasal concha: a rare tumor of the facial massif that should be taken into consideration]. / Ostéoblastome du cornet moyen: tumeur rare du massif facial à ne pas méconnaitre.

Osteoblastoma is a rare benign bone tumor, accounting for 1% of all bone tumors. It mainly occurs in the long bones, more rarely in the jaws. Osteoblastoma of the jaws mainly involves the mandible while nasosinusal involvement is very rare. The diameter of the tumor can grow to 10 cm. On X-ray, the tumor may appear as a well or poorly defined clear lesion, usually scattered with mineral patches. Recurrence rate is very low after surgical resection as well as the risk of malignant transformation. We report the case of a 13-year old female patient presenting with nasal obstruction evolving over the last 3 months associated with episodes of epistaxis and left blurred vision. Clinical examination showed voluminous nasal concha with polyploid mucosa filling all the left nasal fossa with left axial exophthalmos. CT scan of the facial massif showed left frontoethmoidal expansive process measuring 50*47*36 mm, spontaneously hypodense, heterogeneous, non enhanced after injection of the Contrast materials, responsible for destruction of the ethmoidal labyrinth, swelling of the bony walls with mass effect on the ipsilateral orbit. The suspected diagnosis was frontoethmoidal mucocele. Hence, the decision to perform endonasal surgery. Whitish thick liquid was collected by the cranial portion of the middle nasal concha sugesting infected mucocele. Resection of the middle nasal concha was performed. The histological examination showed osteoblastoma of the middle nasal concha . Outcome was marked by regression of the exophthalmos with no recurrence during 1-year follow up period.

Complex odontoma of the nasal cavity: a case report.

We describe the case of a 76-year-old man who presented with symptoms of chronic nasal obstruction and recurrent sinusitis of many years' duration. The patient's history and radiographic findings established a diagnosis of a complex odontoma of the nasal cavity. The mass was surgically excised, and the diagnosis was confirmed by histopathology. The occurrence of an odontoma in the nasal cavity is extremely rare.

Vascular leiomyoma of the nasal vestibule. Case report and literature review.

OBJECTIVES: Vascular leiomyoma (angioleiomyoma) of the nasal cavity is an extremely rare tumour. Following a thorough review of relevant literature, we found that such tumours are more common in females. Only 4 of 30 reported cases have been found in male patients. Moreover, considering the site of the lesion within the nasal cavity, only 3 of these 30 cases originated from the nasal vestibule. Hereby, we present a case of vascular leiomyoma arising specifically from the floor of the nasal vestibule in a 68-year-old man, which is unique because it combines the specific tumour localization with the patient's gender. CASE REPORT: The patient was treated surgically. The tumour was completely removed through an intraoral incision. CONCLUSIONS: This is the first reported case of vascular leiomyoma arising from the floor of the nasal vestibule affecting a male patient.

Diagnostic accuracy of contrast-enhanced computed tomography for assessment of mandibular and medial retropharyngeal lymph node metastasis in dogs with oral and nasal cancer.

The diagnostic accuracy of contrast-enhanced CT for detection of cervical lymph node metastasis in dogs is unknown. The purpose of this retrospective, observational, diagnostic accuracy study was to assess the efficacy of CT for detection of mandibular and medial retropharyngeal lymph node metastasis in dogs. Histopathology of dogs with cancer of the head, CT and bilateral mandibular and medial retropharyngeal lymphadenectomy was reviewed. A single radiologist measured lymph nodes to derive short axis width and long-short axis ratios. Two blinded radiologists separately assessed lymph node margins, attenuation and contrast enhancement and each provided a final subjective interpretation of each node site as benign or neoplastic. Where radiologists' opinions differed, a consensus was reached. Sensitivity, specificity and accuracy were calculated for mandibular and medial retropharyngeal sites. Agreement between radiologists was assessed. Fisher's exact test and the Kruskal-Wallis H-test were used to assess associations between variables. Forty-one primary tumours were recorded in 40 dogs. Metastasis to mandibular or retropharyngeal lymph nodes occurred in 16 out of 40 dogs (43/160 nodes). Agreement between radiologists was almost perfect for margination, attenuation and enhancement, strong for interpretation of mandibular lymph node metastasis, and weak for interpretation of medial retropharyngeal lymph node metastasis. Sensitivity of CT was 12.5% and 10.5%, specificity was 91.1% and 96.7%, and accuracy was 67.5% and 76.3% for mandibular and medial retropharyngeal lymph nodes respectively. No individual CT findings were predictive of nodal metastasis. Given the low sensitivity of CT, this modality cannot be relied upon alone for assessment of cervical lymph node metastasis in dogs.

[Giant cell reparative granuloma originating from the paranasal sinus: a case report].

A 40-year-old man presented with a 10-year history of nasal obstruction of his left nose, a 1-year history of headache and orbital pain. Radiologically, an extensive paranasal sinus mass was seen. Superiorly ,the cribriform plate was demineralized, and the lesion had intracranial extension with mild mass effect over the basal frontal lobes. Histologic examination revealed a central giant cell reparative granuloma. After endoscopic removal, the patient was symptom free at the 2-month follow-up.