Diffuse spinal cord metastasis after resection of SMARCB1 sinonasal carcinoma manifesting with a right foot drop-a case report.

INTRODUCTION: The sinonasal carcinoma are rare tumors of the head and neck. The undifferentiated sinonasal carcinoma subtypes are constantly being explored and new mutations, with different prognosis markers and biological behaviors are being described. The SMARCB1 negative sinonasal carcinoma subtypes have been recently described with few reports of leptomeningeal and spinal cord invasion. CASE PRESENTATION: This study presents the case of a 59-year-old woman, with no previous disease, presenting initially with epistaxis that evolved to cranial nerve deficits and a left eye complete oftalmoplegia. After diagnostic investigation, she had a diagnosis of a left ethmoid sinus sinonasal carcinoma. Following resection of the tumor, she evolved with a right foot drop that eventually has been linked to diffuse spinal cord impairment. The histopathological diagnosis confirmed a SMARCB1 negative sinonasal carcinoma. Due to the diffuse metastasis, she underwent palliative care and died eight months after the surgery. DISCUSSION: Spinal cord metastasis may manifest with different clinical signs. Our case shows a rare manifestation of SMARCB1-deficient sinonasal carcinoma, a new subtype of sinonasal carcinoma, summarizing the importance of a high grade of suspicion of spinal cord invasion on these patients. SMARCB1 sinonasal carcinomas are rare new tumors of the head and neck, whose biological behaviors are yet to be explored. To the best of our knowledge, this is one of the few case reports describing simultaneous spread of this tumor to the central nervous system and spinal cord.

Sonda de Foley como auxiliar na reconstrução de terço médio de face / Foley´s cateter as a coadjuvant on middle face reconstruction / Sonda de Foley como um auxilio para reconstrucciones de terzo medio de la cara

Objetivos: O carcinoma adenoide cístico é uma lesão rara e agressiva. O presente trabalho visa relatar o caso de uma ressecção de carcinoma adenoide cístico e manutenção do arcabouço ósseo realizado por meio de sonda de Foley insuflada com soro fisiológico. Relato do caso: Um paciente submetido a ressecação de um carcinoma adenoide cístico em maxilla com destruição de soalho de órbita foi relatado. O caso foi realizado no Hospital Josina Machel em Luanda, Angola. A região apresenta uma considerável escassez de materiais de fixação e outros mais, o que impossibilita reconstruções maxilofaciais com a excelência necessária. A realização de enxertos microvascularizados ou implantes customizados torna-se inviável devido aos custos e tecnologia dispendida para tal. Conclusão: A sonda de Foley mostra-se como uma alternativa viável nos casos de reconstrução de terço médio de face com envolvimento de seio maxilar e soalho de órbita em locais de mais difícil acesso... (AU)

Objectives: Adenoid cystic carcinoma is a rare and aggressive lesion. The present work aims to report the case of a resection of adenoid cystic carcinoma and maintenance of the bone framework performed using a Foley catheter insufflated with saline solution. Case report: A patient who underwent resection of an adenoid cystic carcinoma in the maxilla with destruction of the orbital floor was reported. The case was carried out at Hospital Josina Machel in Luanda, Angola. The region has a considerable shortage of fixation materials and others, which makes maxillofacial reconstructions with the necessary excellence impossible. The realization of microvascularized grafts or customized implants becomes unfeasible due to the costs and technology used for this purpose. Conclusion: The Foley catheter is a viable alternative in cases of reconstruction of the middle third of the face with involvement of the maxillary sinus and orbital floor in areas that are more difficult to access... (AU)

Objetivos: El carcinoma adenoide quístico es una lesión rara y agresiva. El presente trabajo tiene como objetivo reportar el caso de una resección de carcinoma quístico adenoide y mantenimiento de la estructura ósea realizada mediante sonda de Foley insuflada con suero fisiológico. Caso clínico: Se reporta un paciente que fue sometido a resección de un carcinoma adenoide quístico en el maxilar con destrucción del piso orbitario. El caso se llevó a cabo en el Hospital Josina Machel de Luanda, Angola. La región tiene una escasez considerable de materiales de fijación y otros, lo que imposibilita las reconstrucciones maxilofaciales con la excelencia necesaria. La realización de injertos microvascularizados o implantes personalizados se vuelve inviable por los costes y la tecnología utilizada para tal fin. Conclusión: La sonda de Foley es una alternativa viable en los casos de reconstrucción del tercio medio de la cara con afectación del seno maxilar y suelo orbitario en zonas de más difícil acceso... (AU)

Oral involvement of sinonasal undifferentiated carcinoma: A case report and immunohistochemical study of a challenging case.

INTRODUCTION: Sinonasal undifferentiated carcinoma (SNUC) is a rare tumor highly aggressive most frequently arise in the maxillary sinus and nasal cavity. Oral involvement is extremely rare. CASE REPORT: A 62-years-old male presents a large infiltrative mass involving the hard palate and left alveolar ridge. Computed tomography showed bone destruction and invasion of paranasal sinuses and orbits. Histology revealed a malignant neoplasm consisting of small round cells with minimal cytoplasm and hyperchromatic nuclei without any connection with the oral mucosal epithelium. Immunohistochemical analysis showed epithelial origin (CK-7+, CK-20+, AE1/AE3+, EMA+) and lacked strong evidence of squamous and neuroendocrine differentiation (p63-, 34ßE12-, NSE-/+, chromogranin-, synaptophysin-). TTF-1 negative ruled out the metastatic origin. A diagnosis of SNUC subtype positive for SMARCB1 (INI1) was reached. The patient was submitted to concurrent radiotherapy and chemotherapy without signs of recurrence after 2 years. CONCLUSION: SNUC involving the oral cavity is a rare malignancy that may mimic symptoms of dental infection or sinusitis. A careful correlation of clinical, microscopic, and immunohistochemical characteristics is mandatory for early diagnosis.

Manejo cirúrgico combinado de comunicação buco-sinusal e reconstrução de tábua óssea vestibular usando fibrina rica em plaquetas e leucócitos / Combined surgical management of oroantral communication and buccal bone plate reconstruction using leukocyte- and platelet-rich fibrin

Introdução: A comunicação buco-sinusal é tida como uma comunicação entre a cavidade bucal e o seio maxilar, cuja qual possui variadas etiologias, sendo a mais comum a extração de dentes posteriores superiores, pela proximidade de seus ápices radiculares com o assoalho do seio maxilar. O diagnóstico é obtido a partir da combinação de anamnese, exame físico e exames imaginológicos, podendo ser por meio de radiografias ou tomografia. Há diversas abordagens para o tratamento, incluindo o uso de membranas de Fibrina Rica em Plaqueta e Leucócitos para obstrução local da comunicação. O objetivo deste trabalho é relatar e discutir o emprego de membrana de Fibrina Rica em Plaqueta e Leucócitos para manejo de uma comunicação buco-sinusal associado à reconstrução de tábua óssea vestibular com Stick Bone. Relato de caso: Mulher, 61 anos, compareceu ao atendimento odontológico relatando incômodo na região do dente 16 e história de extração do mesmo há cerca de 8 meses. Ao exame intra-oral, observou-se a presença área hiperemiada no alvéolo da região da extração e, ao exame tomográfico, foi observada solução de continuidade no assoalho do seio maxilar, sugerindo comunicação buco-sinusal associado à perda de tábua óssea vestibular local. Considerações Finais: Portanto, o uso destas membranas são adequados para obstrução destas comunicações, sendo um plugue adequado devido às suas propriedades adesivas na área de perfuração, não estar vinculado a nenhuma reação imunológica, preparação fácil e rápida, altamente biocompatível, baixo custo, prevenção da profundidade do sulco vestibular e não apresentar nenhum risco de infecção... (AU)

Introduction: The oroantral communication is a communication between the oral cavity and the maxillary sinus, which has different etiologies, being the most common the extraction of upper posterior teeth, due to the proximity of their root apexes to the floor of the maxillary sinus. Diagnosis is obtained from a combination of anamnesis, physical examination and imaging exams, which may be through radiographs or tomography. There are several approaches to treatment, including the use of Leukocyte- and Platelet-RichFibrin membranes for local obstruction of communication. The aim of this work is to report and discuss the use of a Leukocyte- and Platelet-Rich Fibrin membrane for the management of oroantral communication associated with the reconstruction of the buccal bone plate with Stick Bone. Case report: A 61-year-old woman reported discomfort in the region of right maxillary first molar and a history of extraction of the same for about 8 months. The intraoral evaluation revealed the presence of a hyperemic area in the alveolus of the extraction region, and the tomographic examination revealed an oroantral communication associated with loss of local vestibular bone plate. Final considerations: Therefore, the use of these membranes are suitable for obstructing these communications, being a propper plug due to its adhesive properties in the perforation area, not being associated to any immunological reaction, easy and fast preparation, highly biocompatible, low cost, prevention of the depth of the vestibular sulcus and do not present any risk of infection... (AU)

Does evaluation of tumor volume or/both origination site better guide to optimal surgery for inverted papilloma? / A avaliação do volume do tumor e/ou dos seus locais de origem fornece a melhor orientação para a técnica cirúrgica ideal do papiloma invertido?

Abstract Introduction Sinonasal inverted papilloma is noted for its high rate of recurrence. Staging systems aid to reduce recurrence and avoid excessive surgeries by guiding the selection of the optimal surgical approach. Objective To evaluate the effectiveness of different endoscopic approaches in inverted papilloma by assessing tumor origin site and tumor volume. Methods Krouse classification system that is based on tumor volume was used for staging; furthermore, tumor origin sites were grouped as lateral nasal wall, medial wall and other walls of maxillary sinus. The main treatment method for all patients was endoscopic sinus surgery. Endoscopic extended middle meatal antrostomy, endoscopic Caldwell-Luc and endoscopic medial maxillectomy were the additional surgery types performed in different combinations. Results Fifty-five patients (42 male) with a mean 54.9 ± 14.4 years of age were included. 37 patients were diagnosed with advanced stage inverted papilloma (67.2 %). Recurrence was observed in 12 patients (21.8 %). In early stage lateral nasal wall origination, no recurrence was observed in the simple tumor resection group (0/10). In early stage medial wall origination, no recurrence was observed in the extended middle meatal antrostomy group (0/8). In advanced stage medial wall origination, the recurrence rates of extended middle meatal antrostomy, extended middle meatal antrostomy + endoscopic Caldwell- Luc and endoscopic medial maxillectomy were 100.0 %, 53.8 % and 13.6 %, respectively (p = 0.002). In advanced stage other walls of maxillary sinus origination, recurrence rates of extended middle meatal antrostomy + endoscopic Caldwell-Luc and endoscopic medial maxillectomy were 20 % and 16.6 %, respectively (p = 0.887). Conclusion Tumor origin site, tumor stage and surgery types show an impact on recurrence. Despite the fact that tumor origin site singly could lead to appropriate selection of the surgery type in most cases, tumor stage carries substantial importance in selection of surgery type for sinonasal-inverted papilloma. An operation plan regarding both tumor volume and tumor origin site may aid surgeons in selecting optimal endoscopic surgical method to avoid recurrence or excessive surgeries.

Resumo Introdução O papiloma invertido nasossinusal é conhecido por sua alta taxa de recorrência. Os sistemas de estadiamento ajudam a reduzir a recorrência e evitar cirurgias excessivas e orientam a seleção da abordagem cirúrgica ideal. Objetivo Avaliar a eficácia de diferentes abordagens endoscópicas no papiloma invertido, de acordo com o local de origem e o volume do tumor. Método Para o estadiamento, usou-se o sistema de classificação de Krouse, baseado no volume do tumor; além disso, os tumores foram agrupados de acordo com seus locais de origem: parede nasal lateral, parede medial e outras paredes do seio maxilar. O principal método de tratamento para todos os pacientes foi a cirurgia endoscópica nasossinusal. Foram feitos, em diferentes combinações, os seguintes tipos de cirurgia: antrostomia estendida do meato médio, Caldwell-Luc endoscópica e maxilectomia medial endoscópica. Resultados Foram incluídos 55 pacientes (42 homens) com média de 54,9 ± 14,4 anos. Trinta e sete pacientes foram diagnosticados com papiloma invertido avançado (67,2%). Foi observada recorrência em 12 pacientes (21,8%). No estágio inicial com origem na parede nasal lateral, não foi observada recorrência no grupo de ressecção simples de tumor (0/10). No estágio inicial com origem na parede medial, não foi observada recorrência no grupo de antrostomia estendida do meato médio (0/8). Com tumor em estágio avançado com origem na parede medial, as taxas de recorrência na antrostomia estendida do meato médio, antrostomia estendida do meato médio + Caldwell-Luc endoscópica e maxilectomia medial endoscópica foram de 100,0%, 53,8% e 13,6%, respectivamente (p = 0,002). No tumor em estágio avançado em outras paredes do seio maxilar, as taxas de recorrência na antrostomia estendida do meato médio + Caldwell-Luc endoscópica e maxilectomia medial endoscópica foram de 20% e 16,6%, respectivamente (p = 0,887). Conclusão O local de origem do tumor, o estágio do tumor e os tipos de cirurgia mostram impacto na recorrência. Apesar da consideração de que na maioria dos casos o local de origem do tumor pode, de forma isolada, orientar a seleção apropriada do tipo de cirurgia, o estágio do tumor tem importância substancial na seleção do tipo de cirurgia para papiloma invertido nasossinusal. Um planejamento cirúrgico considerando tanto o volume quanto o local de origem do tumor pode ajudar os cirurgiões a selecionar o tipo ideal de cirurgia endoscópica para evitar recorrências ou remoções excessivas.

Tumores de Fosa Pterigopalatina: Tipos de abordajes quirúrgicos y complicaciones / Pterygopalatine Fossa Tumors: Types of surgical approaches and complications

INTRODUCCIÓN. La fosa pterigopalatina es una zona anatómica de difícil acceso, que al presentar masas tumorales genera un alto riesgo de morbimortalidad en población juvenil y adulta, que precisa determinar las complicaciones asociadas a cirugía. OBJETIVO. Evaluar los tipos de abordaje quirúrgico, complicaciones e identificar la estirpe histológica de los tumores de fosa pte-rigopalatina. MATERIALES Y MÉTODOS. Estudio transversal retrospectivo. Población y muestra conocida de 29 Historias Clínicas de pacientes con hallazgos de imagen e histopatológico de tumores con invasión a fosa pterigopalatina divididos en dos grupos: A) resección de masa tumoral y B) biopsia de masa tumoral, operados en el Hospital de Especialidades Carlos Andrade Marín en el período de enero 2017 a diciembre de 2020. RESULTADOS. El 82,76% (24; 29) fueron hombres, con promedio de edad de 30,6 años. El 82,76% (24; 29) de las masas tumorales se originaron en nasofaringe; no se reportaron casos primarios. El tumor más frecuente fue el Angio-fibroma Nasofaringeo Juvenil 68,97% (20; 29), seguido por los tumores malignos con el 20,69% (6; 29), siendo usual el carcinoma adenoideo quístico. En el 62,07% (18; 29) el tumor invadió Fosa Infratemporal y en el 44,83% (13; 29) hacia esfenoides. En el grupo A, el abordaje quirúrgico empleado en el 20,83% (5; 24) fue mediante técnica abierta y en el 79,17% (19; 24) con técnica endoscópica, tanto uni 31,58% (6; 19) como multiportal 68,42% (13; 19). La complicación fue la hiposensibilidad facial en el 12,5% (3; 24), todos en abordajes abiertos. CONCLUSIÓN. Se evaluó los tipos abordaje quirúrgico y se identificó la estirpe histológica de los tumores de fosa pterigopalatina

INTRODUCTION. The pterygopalatine fossa is an anatomical area of difficult access, which when presenting tumor masses generates a high risk of morbimortality in the juvenile and adult popula-tion, which needs to determine the complications associated with surgery. OBJECTIVE. To eva-luate the types of surgical approach, complications and identify the histologic type of pterygopala-tine fossa tumors. MATERIALS AND METHODS. Retrospective cross-sectional study. Population and known sample of 29 Clinical Histories of patients with imaging and histopathological findings of tumors with invasion to pterygopalatine fossa divided into two groups: A) resection of tumor mass and B) biopsy of tumor mass, operated at the Carlos Andrade Marín Specialty Hospital in the period from january 2017 to december 2020. RESULTS. The 82,76% (24; 29) were men, with an average age of 30,6 years. 82,76% (24; 29) of the tumor masses originated in nasopharynx; no primary cases were reported. The most frequent tumor was juvenile nasopharyngeal angiofibroma 68,97% (20; 29), followed by malignant tumors with 20,69% (6; 29), being usual the adenoid cystic carcinoma. In 62,07% (18; 29) the tumor invaded the Infratemporal Fossa and in 44,83% (13; 29) into the sphenoid. In group A, the surgical approach used in 20,83% (5; 24) was by open technique and in 79,17% (19; 24) by endoscopic technique, both uni 31,58% (6; 19) and multiportal 68,42% (13; 19). The complication was facial hyposensitivity in 12,5% (3; 24), all in open approaches. CONCLUSION. The types of surgical approach were evaluated and the histologic type of pterygo-palatine fossa tumors was identified.

Does evaluation of tumor volume or/both origination site better guide to optimal surgery for inverted papilloma?

INTRODUCTION: Sinonasal inverted papilloma is noted for its high rate of recurrence. Staging systems aid to reduce recurrence and avoid excessive surgeries by guiding the selection of the optimal surgical approach. OBJECTIVE: To evaluate the effectiveness of different endoscopic approaches in inverted papilloma by assessing tumor origin site and tumor volume. METHODS: Krouse classification system that is based on tumor volume was used for staging; furthermore, tumor origin sites were grouped as lateral nasal wall, medial wall and other walls of maxillary sinus. The main treatment method for all patients was endoscopic sinus surgery. Endoscopic extended middle meatal antrostomy, endoscopic Caldwell-Luc and endoscopic medial maxillectomy were the additional surgery types performed in different combinations. RESULTS: Fifty-five patients (42 male) with a mean 54.9±14.4 years of age were included. 37 patients were diagnosed with advanced stage inverted papilloma (67.2 %). Recurrence was observed in 12 patients (21.8 %). In early stage lateral nasal wall origination, no recurrence was observed in the simple tumor resection group (0/10). In early stage medial wall origination, no recurrence was observed in the extended middle meatal antrostomy group (0/8). In advanced stage medial wall origination, the recurrence rates of extended middle meatal antrostomy, extended middle meatal antrostomy+endoscopic Caldwell- Luc and endoscopic medial maxillectomy were 100.0 %, 53.8 % and 13.6 %, respectively (p=0.002). In advanced stage other walls of maxillary sinus origination, recurrence rates of extended middle meatal antrostomy+endoscopic Caldwell-Luc and endoscopic medial maxillectomy were 20 % and 16.6 %, respectively (p=0.887). CONCLUSION: Tumor origin site, tumor stage and surgery types show an impact on recurrence. Despite the fact that tumor origin site singly could lead to appropriate selection of the surgery type in most cases, tumor stage carries substantial importance in selection of surgery type for sinonasal-inverted papilloma. An operation plan regarding both tumor volume and tumor origin site may aid surgeons in selecting optimal endoscopic surgical method to avoid recurrence or excessive surgeries.

Adenoid cystic carcinoma of head and neck. A 5-year retrospective study: Experience in a single third-level reference center.

INTRODUCTION: Adenoid cystic carcinoma (ACC) is a rare tumor, with an annual incidence of 3-4.5 cases/million. MATERIALS AND METHODS: We conducted a descriptive and retrospective study. We included patients diagnosed with ACC of head and neck of a single third-level referral center, from January 2008 to December 2013. RESULTS: A total of 23 patients were included in the study, 10 males (43.5%) and 13 females (56.5%) (F:M ratio 1.3:1). Median age was 52 years. Localization was predominantly observed in the oral cavity (26%) followed by the palate (17.4%). At presentation, 15 patients (65.2%) had clinical Stage II. The most frequent histology was the cribriform type in 10 patients (43.5%). Following resection, positive margins were observed in 15 (65.2%), neural invasion in 8 (34.8%), and lymphovascular invasion in 2 (8.7%) patients. The median time to recurrence in our population was 23 months. Recurrence at 5 years was observed in 15 patients (65%). At 2 years, recurrence was predominantly local in 7 patients (46%); whereas after 2 years, it was predominantly pulmonary 6 patients (40%). Overall, 5 year-survival was 78%. CONCLUSIONS: Cystic adenoid carcinoma is characterized by a high recurrence rate. Nevertheless, it has a high overall 5-year survival, which justifies an aggressive treatment.

ANTECEDENTES: El carcinoma adenoide quístico es un tumor raro, con una incidencia anual de 3-4.5 casos por millón. MATERIALES Y MÉTODOS: Estudio descriptivo, retrospectivo, que incluyó pacientes con carcinoma adenoide quístico de cabeza y cuello de un centro de referencia de tercer nivel, desde enero de 2008 hasta diciembre de 2013. RESULTADOS: Se incluyeron 23 pacientes, 10 hombres (43.5%) y 13 mujeres (56.5%) (relación 1.3:1), con una media de edad de 52 años. Predominó en la cavidad bucal (26%), seguida del paladar (17.4%). Al diagnóstico, 15 pacientes (65.2%) tenían estadio clínico II. La histología cribiforme fue la más frecuente (10 pacientes; 43.5%). Posterior a la cirugía, se observaron márgenes positivos en 15 (65.2%), invasión neural en 8 (34.8%) e invasión linfovascular en 2 (8.7%) pacientes. La media de recurrencia fue de 23 meses. La recurrencia a 5 años se observó en 15 pacientes (65%). A los 2 años predominó la recurrencia local (7 pacientes; 46%); después de los 2 años predominaron las metástasis pulmonares (6 pacientes; 40%). La supervivencia a 5 años fue del 78%. CONCLUSIONES: El carcinoma adenoide quístico se caracteriza por una alta tasa de recurrencia. Sin embargo, tiene una alta supervivencia global a 5 años, lo que justifica un tratamiento agresivo.

A rare presentation of Sinonasal Undifferentiated Carcinoma with brain metastasis and para-aortic mass

Sinonasal Undifferentiated carcinoma (SNUC) comprises 3% of the head and neck tumors, including metastatic neoplasms. Herein we report the case of a 60-year-old male who was brought dead to our institute with previous records of a contrast-enhanced CT scan of the brain and MRI with evidence of tumor in the maxillary sinus with intracranial extensions. The histopathological examination of the mass in the maxillary sinus proved to be SNUC with metastases to the brain, lungs, and around the aorta. These tumors are undifferentiated and are distinct from other poorly differentiated tumors in deriving their origin from the Schneiderian epithelium. The aggressive nature of the tumor renders the prognosis quite dismal. SNUCs need to be early recognized and distinguished from other poorly differentiated carcinomas with the help of immunohistochemistry.

The first report of molecular characterized BRD4-NUT carcinoma in Brazil: a case report.

BACKGROUND: NUT midline carcinoma is a rare and aggressive subset of squamous cell carcinoma, which is characterized by the translocation of nuclear protein in testis gene that is mostly fused with bromodomain and extraterminal family proteins. We describe here the first Brazilian case of NUT midline carcinoma with BRD4-NUT fusion detected in a next-generation sequencing panel and we present the clinical evolution of this patient. CASE PRESENTATION: A 42-year-old Caucasian man was diagnosed with poorly differentiated squamous cell carcinoma of the left maxillary sinus, with negative in situ hybridization for Epstein-Barr encoding region and human papillomavirus genotyping. He received induction therapy, chemoradiotherapy with weekly systemic chemotherapy, and, concurrently, weekly intra-arterial chemotherapy. New imaging evaluation, 1 month after the end of the last treatment, revealed a good partial response in the primary lesion. However, positron emission tomography-computed tomography showed multiple suspicious lesions in his bones and lungs, which were histologically confirmed. He died exactly 2 months after metastatic disease was diagnosed. CONCLUSIONS: NUT midline carcinoma is usually very aggressive. Currently, there is no standard of care for treatment of NUT midline carcinoma. The definitive diagnosis must be by demonstration of NUTM1 rearrangement. Immunohistochemical staining of greater than 50% of tumor nuclei on formalin-fixed paraffin-embedded tissue using the monoclonal rabbit antibody to NUT (clone C52B1), has a specificity of 100%, and sensitivity of 87% for the diagnosis of NUT midline carcinoma. Our case is the first Brazilian case of NUT midline carcinoma with BRD4-NUT fusion.

Osteoma compacto do seio maxilar ­ relato de caso / Osteoma of the maxillary sinus ­ case report

Os osteomas são tumores benignos de crescimento ósseo, compostos de osso compacto, esponjoso ou misto, comumente associado ao esqueleto craniofacial, com maior frequência nos seios paranasais e menor frequência nos ossos gnáticos. Tem predileção pelo sexo masculino entre a segunda e quinta décadas de vida. Sua etiologia é incerta, podendo estar associada à infecção, trauma, influência genética ou embriológica. O tratamento cirúrgico dos osteomas está reservado para os casos de crescimento rápido, infecção, sintomatologia dolorosa, alteracões funcionais ou deformidades estéticas. Casos de osteomas pequenos e assintomáticos permitem tratamento conservador. O presente trabalho tem por objetivo relatar um caso de osteoma em seio maxilar associado à sintomatologia dolorosa (cefaleia) tratado cirurgicamente (AU).

Osteomas are benign tumors of bone growth, composed of compact, spongy or mixed bones, commonly associated with the craniofacial skeleton, more frequently in the paranasal sinuses and less frequently in the gnathic bones. It mostly affects men between 20 and 50 years old. Its etiology is uncertain and may be associated with infection, trauma, genetic or embryological influence. Surgical treatment of osteomas is reserved for cases of rapid growth, infection, painful symptomatology, functional alterations or aesthetic deformities. Cases of small asymptomatic osteomas allow conservative treatment. The present study aims to report a case of osteoma in the maxillary sinus associated with painful symptomatology (headache) treated surgically (AU).

Fatal primary diffuse large B-cell lymphoma of the maxillary sinus initially treated as an infectious disease in an elderly patient: A clinicopathologic report.

OBJECTIVE: To report a case of primary diffuse large B-cell lymphoma (DLBCL) of the maxillary sinus in an 82-year-old Caucasian woman. BACKGROUND: Diffuse large B-cell lymphoma of the maxillary sinus has non-specific signs and symptoms that may be confused with benign inflammatory conditions and upper respiratory infections. METHODS: An incisional biopsy was performed. CD20+ /CD3- /Ki-67: 95% cells were observed. CONCLUSION: A good medical history, clinical and imaging evaluations and immunohistochemical reactions are crucial to establish a correct and early diagnosis of DLBCL.

Case report. Metastatic renal cell carcinoma to the left maxillary sinus.

Metastatic tumors in the paranasal sinuses are very rare. The origin of metastatic tumors in the paranasal sinuses is often renal cancer. Renal cell carcinomas are known for their tendency for early metastasis, and symptoms due to the metastatic lesion may be the only initial manifestation. In this paper, we deal with the case of a 35-year-old male patient who presented with a mass in the left maxillary region. The presence of a primary renal cell carcinoma was recognized only after surgical removal of the metastatic tumor. The presentation, diagnosis and treatment of this tumor are discussed with a review of the literature.

Abordagem cirúrgica de osteoma em osso frontal: relato de caso / Surgical management of osteoma in the frontal bone: a case report

Os osteomas são tumores de crescimento ósseo benigno, que podem se apresentar de forma compacta, esponjosa ou mista e acometem comumente os ossos do esqueleto crânio facial. Estas lesões podem ser encontradas nos seios paranasais, na maxila, na mandíbula e no osso frontal. Embora possam ser encontrados em qualquer idade, são mais comuns em adultos jovens e não há predileção por gênero. A etiologia dos osteomas é desconhecida, porém pode estar associada a infecções, traumas, influência hormonal ou genética. São neoplasias de crescimento lento, geralmente assintomáticas, embora possam causar alteração funcional ou deformidade facial. O tratamento para os osteomas pode ser conservador ou cirúrgico, a depender do tamanho da lesão, da sintomatologia e da queixa do paciente. O presente trabalho tem como objetivo relatar um caso clínico de uma paciente de 35 anos, que apresentava osteoma em região de osso frontal com importante queixa estética, que foi satisfatoriamente tratada através de acesso coronal, ostectomia e osteoplastia, além de discutir as características clínicas e as formas de tratamento possíveis para esta lesão... (AU)

Osteomas are benign tumors of bone growth, which can present a compact, spongy or mixed form and commonly involve the bones of the craniofacial skeleton. These lesions can be found in the paranasal sinuses, maxilla, mandible, and the frontal bone. Although they can be found at any age, are more common in young adults and there is no gender predilection. The etiology of osteomas is unknown but may be associated with infections, trauma, or genetic influences hormone. Neoplasms are slow growing, usually asymptomatic, but may cause functional alteration or facial deformity. Treatment for osteomas can be conservative or surgical, depending on the size of the lesion, the symptoms and the patient's complaint. This paper aims to report a clinical case of a patient of 35 years who had osteoma in the region of the frontal bone with significant aesthetic complaint, which was successfully treated by coronal access, ostectomy and osteoplasty, and discuss the clinical features and possible forms of treatment for this injury... (AU)