RESUMEN
BACKGROUND: Juvenile Psammomatoid Ossifying Fibroma (JPOF) is a type of noncancerous bone tumor that usually affects adolescents in the craniomaxillofacial area. Clinical manifestations are usually symptoms caused by the tumor's invasive compression of surrounding tissues. Aneurysmal Bone Cyst (ABC) is also a benign bone tumor, and it typically occurs in long bones and the spine. Only 2% to 3% of cases occur in the head and neck. Due to the rarity of this combination of clinical cases, clinicians face difficulties in comprehensively understanding this complex lesion. Therefore, a comprehensive review of the clinical manifestations and characteristic imaging findings is necessary for surgeons. CASE PRESENTATIONS: On April 6, 2019, a 13-year-old boy presented with left maxillofacial bulge and pain for 1 month. Magnetic resonance imaging of the paranasal sinuses showed an irregular hive-like mass signal in the left maxillary sinus, and cystic changes with fluid levels were seen in the lesion. After the initial diagnosis of JPOF with primary ABC, we decided to perform a facial mid-facial resection of maxillary sinus tumor to remove the tumor tissue. Finally, after 3 recurrences and 4 operations, there was no tumor recurrence for 20 months after the last operation, and the patient was still under continuous follow-up. CONCLUSIONS: This case provided a reference for the diagnosis and treatment of JPOF combined with ABC. In particular, a new understanding of the association between the two diseases and the management of recurrence were proposed, which had the potential to improve clinical understanding of this complicated condition.
Asunto(s)
Quistes Óseos Aneurismáticos , Fibroma Osificante , Imagen por Resonancia Magnética , Humanos , Quistes Óseos Aneurismáticos/complicaciones , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/diagnóstico , Masculino , Adolescente , Fibroma Osificante/cirugía , Fibroma Osificante/complicaciones , Fibroma Osificante/diagnóstico por imagen , Fibroma Osificante/diagnóstico , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Seno Maxilar/patologíaRESUMEN
BACKGROUND: Maxillary sinus cancer is a rare disease with heterogeneous biologic behavior. The pattern of neurovascular invasion is known to be an important prognosticator in head and neck cancers, but has not been studied in maxillary malignancies. MATERIALS AND METHODS: Patients undergoing surgery-based treatment with curative intent for a malignancy of the maxillary sinus at the Unit of Otorhinolaryngology - Head and Neck Surgery of the University of Brescia between November 2000 and October 2018 were included. A description of the characteristics of the patients, tumors, and treatments has been performed along with uni- and multi-variate analysis of prognostic factors. Tumors were classified based on the presence of perineural (P0/P1) and lymphovascular invasion (V0/V1) in 4 categories: P0V0, P1V0, P0V1, and P1V1. RESULTS: One hundred-thirty-eight patients were included. Mean age at surgery was 61.0 years. Most patients (60.1%) were affected by non-salivary carcinomas, and most tumors (73.9%) were high-grade cancers. One hundred-seven (77.5%) tumors were classified as pT4. The large majority of patients received bi- or tri-modality treatment. Sixty-three (45.7%) cases were classified as P0V0, 32 (23.2%) as P1V0, 7 (5.1%) as P0V1, and 36 (26.1%) as P1V1. T category, nodal status, and neurovascular invasion were significantly associated with prognosis. Perineural and lymphovascular invasion were associated with the topographical growth of the tumor. CONCLUSIONS: Maxillary cancer is often diagnosed at an advanced stage and in most cases requires a multimodal approach. Perineural and lymphovascular invasion are frequent and have a different impact on prognosis and topographical extension of the tumor.
Asunto(s)
Neoplasias del Seno Maxilar/complicaciones , Femenino , Humanos , Masculino , Neoplasias del Seno Maxilar/mortalidad , Neoplasias del Seno Maxilar/patología , Persona de Mediana Edad , Invasividad Neoplásica , Pronóstico , Análisis de SupervivenciaRESUMEN
A multitude of disease processes ranging from periodontitis to malignancies can lead to formation of solitary ulcer on the palate. Hence solitary ulcers of palate can often be a challenging one to diagnose. We report an interesting case of a diffuse large B cell lymphoma of the maxillary sinus which perforated the palatal bone and presented clinically as a palatal ulcer. Initially the lesion manifested as a small ill-defined swelling in the posterior palatal slope in relation to 24and25 which were mobile and hence was erroneously diagnosed as chronic periodontal abscess. This paper is intended to stress the relevance of including non-Hodgkin's lymphoma in the differential diagnosis of solitary palatal ulcers as it may be often misdiagnosed as more common reactive or inflammatory lesions.
Asunto(s)
Linfoma de Células B Grandes Difuso/patología , Neoplasias del Seno Maxilar/patología , Úlceras Bucales/patología , Hueso Paladar/patología , Adulto , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Linfoma de Células B Grandes Difuso/complicaciones , Linfoma de Células B Grandes Difuso/diagnóstico por imagen , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/diagnóstico por imagen , Úlceras Bucales/etiologíaRESUMEN
We report a rare case of sinonasal inverted papilloma (IP) associated with small cell neuroendocrine carcinoma (SNEC). To our knowledge, this is the first report to describe SNEC found during the treatment of sinonasal IP. Surgery and five cycles of cisplatin plus etoposide with concurrent intensity modulated radiation therapy were performed. Neither local recurrence nor distant metastasis was noted during 6 years of post-diagnostic follow-up. The prognosis of SNEC is very poor. Treatment planning for sinonasal IP should consider a possible association with this rare but aggressive malignancy, whose treatment is completely different from that of squamous cell carcinoma, a malignancy which is commonly associated with IP. We also performed a PubMed review of the literature to identify the incidence and pathological diagnosis of associated malignancy. Among a total of 5286 cases of sinonasal IP (61 studies), the incidence of associated malignancy was 8.02% in squamous cell carcinoma, 0.19% in transitional cell carcinoma, 0.04% in mucoepidermoid carcinoma, 0.02% in verrucous cell carcinoma and 0.02% in adenocarcinoma. The incidence of associated malignancy was significantly higher in East and Southeast Asia (11.0%) and North America (10.4%) than in Europe (3.9%) (p=0.04 and p=0.03, respectively; T-test).
Asunto(s)
Carcinoma Neuroendocrino/complicaciones , Carcinoma de Células Pequeñas/complicaciones , Neoplasias del Seno Maxilar/complicaciones , Pólipos Nasales/complicaciones , Neoplasias Nasales/complicaciones , Papiloma Invertido/complicaciones , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma Neuroendocrino/diagnóstico por imagen , Carcinoma Neuroendocrino/patología , Carcinoma Neuroendocrino/terapia , Carcinoma de Células Pequeñas/diagnóstico por imagen , Carcinoma de Células Pequeñas/patología , Carcinoma de Células Pequeñas/terapia , Cisplatino/administración & dosificación , Etopósido/administración & dosificación , Femenino , Humanos , Neoplasias del Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/patología , Neoplasias del Seno Maxilar/terapia , Obstrucción Nasal/etiología , Pólipos Nasales/diagnóstico por imagen , Pólipos Nasales/patología , Pólipos Nasales/cirugía , Neoplasias Nasales/diagnóstico por imagen , Neoplasias Nasales/patología , Neoplasias Nasales/cirugía , Procedimientos Quirúrgicos Otorrinolaringológicos , Papiloma Invertido/diagnóstico por imagen , Papiloma Invertido/patología , Papiloma Invertido/cirugía , Radioterapia de Intensidad ModuladaRESUMEN
Adenoid cystic carcinoma (ACC) is a rare malignant secretory gland tumor. It is characterized by slow growth, long clinical course, local recurrences, and distant metastases. In the sinonasal tract, it most commonly arises in the maxillary sinus. It often presents at an advanced stage with perineural spread (PNS). Our patient presented with left-sided facial numbness without other symptoms. The numbness was localized to the left cheek, left side of nose, and left upper lip. Magnetic resonance imaging (MRI) of the brain revealed an enhancing lesion involving the left maxillary sinus with orbital invasion and posterior extension into the cavernous sinus. Transnasal endoscopic exploration with tissue removal revealed ACC. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scan revealed no evidence of distant metastases. Presentation of sinonasal ACC (SNACC) is variable depending on the involved structures. Characteristic PNS with ACC may cause neuropathic symptoms. This case displays a unique presentation of an advanced ACC of the maxillary sinus manifesting as isolated unilateral trigeminal anesthesia without sinonasal symptoms. The patient also failed to demonstrate any ocular or oculomotor symptoms despite extensive involvement of the orbit and surrounding structures. This case highlights the importance of recognizing ACC due to its association with late symptomatic manifestations. It also reinforces the need for clinical diligence with the workup of new onset neuropathic symptoms in the maxillary distribution of the trigeminal nerve.
Asunto(s)
Carcinoma Adenoide Quístico/complicaciones , Hipoestesia/etiología , Neoplasias del Seno Maxilar/complicaciones , Seno Maxilar , Enfermedades del Nervio Trigémino/etiología , Carcinoma Adenoide Quístico/diagnóstico por imagen , Carcinoma Adenoide Quístico/patología , Seno Cavernoso/diagnóstico por imagen , Seno Cavernoso/patología , Humanos , Imagen por Resonancia Magnética , Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/patología , Órbita/diagnóstico por imagenRESUMEN
Head and neck sarcomas are rare and consist of a variety of histologic subtypes. We present a case of undifferentiated/unclassified sarcoma (UUS) of the maxillary sinus, a tumor subtype historically known as malignant fibrous histiocytoma (MFH) or undifferentiated pleomorphic sarcoma (UPS). A 50-year-old female patient presented with worsening facial pain and dysphagia. Physical examination demonstrated a large, ulcerated mass protruding from the oral cavity. Computed tomography demonstrated a large, enhancing mass centered in the right maxillary sinus with local invasion. The initial biopsy was read as "central giant cell granuloma." Conservative management yielded no improvement, and the tumor grew steadily. The patient underwent a total maxillectomy with resection of the orbital floor and an anterior ethmoidectomy, followed by radiation and chemotherapy. In addition to treatment of this patient, we discuss a review of the literature and the clinical presentation, radiologic, and histologic findings of this disease.
Asunto(s)
Trastornos de Deglución/etiología , Dolor Facial/etiología , Histiocitoma Fibroso Maligno/patología , Neoplasias del Seno Maxilar/patología , Sarcoma/patología , Femenino , Histiocitoma Fibroso Maligno/complicaciones , Humanos , Neoplasias del Seno Maxilar/complicaciones , Persona de Mediana Edad , Sarcoma/complicacionesRESUMEN
Paranasal fibrosarcoma of nasal cavity and paranasal sinuses is a very rare malignant tumor. It is usually presented with nasal obstruction and epistaxis. In this clinical report, clinical symptoms, pathogenesis, and treatment principles of a paranasal fibrosarcoma originating from the right maxillary sinus and obstructing the right nasal passage are discussed.A 55-year-old male patient was admitted to the authors clinic with complaints of nasal obstruction and epistaxis lasting for 2 years. Anterior rhinoscopy revealed a mass lesion which obstructed the right nasal passage and caused frequent epistaxis. An opacity consistent with soft tissue lesion which was originated from the right maxillary sinus and filled the right nasal passage was observed in paranasal tomography. Magnetic resonance imaging revealed that the mass lesion was contrasted. Tumor was seen to erode orbital floor, and lateral and anterior walls of the maxillary sinus. Biopsy result was reported as papilloma. The patient was treated with Denker approach as anterior wall of the maxillary sinus was eroded by the tumor lesion and the mass lesion was excised. The patient received postoperative radiotherapy as pathological diagnosis was reported as paranasal fibrosarcoma.
Asunto(s)
Fibrosarcoma , Neoplasias del Seno Maxilar , Diagnóstico Diferencial , Endoscopía , Epistaxis/etiología , Fibrosarcoma/complicaciones , Fibrosarcoma/diagnóstico por imagen , Fibrosarcoma/patología , Fibrosarcoma/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/patología , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/patología , Neoplasias del Seno Maxilar/cirugía , Persona de Mediana Edad , Cavidad Nasal/patología , Obstrucción Nasal/etiología , Órbita/patología , Tomografía Computarizada por Rayos XAsunto(s)
Adenocarcinoma/complicaciones , Adenocarcinoma/diagnóstico , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/diagnóstico , Reflejo Trigeminocardíaco , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Humanos , Masculino , Neoplasias del Seno Maxilar/patología , Neoplasias del Seno Maxilar/cirugía , Persona de Mediana EdadRESUMEN
OBJECTIVE: The aim of this study was to investigate the clinical features and prognosis of patients with squamous cell carcinoma (SCC) associated with sinonasal inverted papilloma (IP). METHODS: The medical records of 95 patients who were diagnosed with IP or SCC associated with IP were retrospectively reviewed. Out of 95 patients, 15 were diagnosed with SCC associated with IP. The clinical characteristics, treatment modalities, and survival outcomes of the patients were analyzed. RESULTS: The incidence of SCC associated with IP was 15.8%. Although differential diagnosis between IP and SCC associated with IP is difficult, epistaxis may be the specific symptom in SCC associated with IP cases. The 3-year disease-specific survival rate was higher in cases with T1, 2 and 3 than in cases with T4. There was no significant difference in survival rate between maxillary sinus and other primary sites. On the other hand, there was a significant difference in survival rate between the microscopic SCC with IP cases and the other cases. In addition, the patients with <70 years old better than those with >70 years old with a 3-year disease free survival of 80% versus 0%. CONCLUSIONS: Some T4 patients were found to have a highly aggressive disease. Therefore, complete surgical resection followed by chemo-radiation therapy is the recommended treatment for patients with T4 disease to control of the primary tumor site.
Asunto(s)
Antineoplásicos/uso terapéutico , Carcinoma de Células Escamosas/terapia , Quimioradioterapia Adyuvante , Neoplasias de Cabeza y Cuello/terapia , Neoplasias del Seno Maxilar/terapia , Neoplasias Primarias Múltiples/terapia , Neoplasias Nasales/terapia , Procedimientos Quirúrgicos Otorrinolaringológicos , Papiloma Invertido/terapia , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Supervivencia sin Enfermedad , Combinación de Medicamentos , Epistaxis/etiología , Femenino , Fluorouracilo/uso terapéutico , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/patología , Humanos , Estimación de Kaplan-Meier , Imagen por Resonancia Magnética , Masculino , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/patología , Persona de Mediana Edad , Cavidad Nasal , Obstrucción Nasal/etiología , Estadificación de Neoplasias , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/diagnóstico por imagen , Neoplasias Primarias Múltiples/patología , Neoplasias Nasales/complicaciones , Neoplasias Nasales/diagnóstico por imagen , Neoplasias Nasales/patología , Ácido Oxónico/uso terapéutico , Papiloma Invertido/complicaciones , Papiloma Invertido/diagnóstico por imagen , Papiloma Invertido/patología , Neoplasias de los Senos Paranasales/complicaciones , Neoplasias de los Senos Paranasales/diagnóstico por imagen , Neoplasias de los Senos Paranasales/patología , Neoplasias de los Senos Paranasales/terapia , Radioterapia Adyuvante , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello , Tegafur/uso terapéutico , Tomografía Computarizada por Rayos XAsunto(s)
Endoscopía , Neoplasias del Seno Maxilar/cirugía , Seno Maxilar , Quistes Odontogénicos/cirugía , Tumores Odontogénicos/cirugía , Adolescente , Niño , Femenino , Humanos , Masculino , Neoplasias del Seno Maxilar/complicaciones , Persona de Mediana Edad , Quistes Odontogénicos/complicaciones , Tumores Odontogénicos/complicacionesAsunto(s)
Diplopía/diagnóstico , Neoplasias del Seno Maxilar/diagnóstico , Neoplasias del Seno Maxilar/terapia , Respiración por la Boca/diagnóstico , Plasmacitoma/diagnóstico , Plasmacitoma/terapia , Diagnóstico Diferencial , Diplopía/etiología , Diplopía/prevención & control , Humanos , Masculino , Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/complicaciones , Persona de Mediana Edad , Respiración por la Boca/etiología , Respiración por la Boca/prevención & control , Plasmacitoma/complicacionesAsunto(s)
Carcinoma de Células Escamosas/diagnóstico , Neoplasias del Seno Maxilar/diagnóstico , Tercer Molar , Diente Impactado/etiología , Odontalgia/etiología , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/patología , Persona de Mediana Edad , Diente Impactado/diagnóstico , Odontalgia/diagnósticoRESUMEN
Sinonasal undifferentiated carcinoma-related rhinogenic optic neuropathy is rare and may lead to visual loss. To the best of our knowledge, this is the first report of bilateral sequential visual loss induced by this etiology. It is important to differentiate between chronic sinusitis and malignancy on the basis of specific findings on magnetic resonance images. Surgical decompression with multidisciplinary therapy, including steroids, chemotherapy, and radiotherapy, is indicated. However, no visual improvement was noted in this case, emphasizing the rapid disease progression and importance of early diagnosis and treatment.
Asunto(s)
Carcinoma/diagnóstico , Neoplasias del Seno Maxilar/diagnóstico , Enfermedades del Nervio Óptico/complicaciones , Nervio Óptico/diagnóstico por imagen , Sinusitis/diagnóstico , Baja Visión/etiología , Anciano , Carcinoma/complicaciones , Carcinoma/cirugía , Enfermedad Crónica , Descompresión Quirúrgica , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/cirugía , Enfermedades del Nervio Óptico/diagnóstico , Enfermedades del Nervio Óptico/cirugía , Tomografía Computarizada por Rayos X/métodos , Baja Visión/diagnóstico , Baja Visión/cirugíaRESUMEN
No disponible
Asunto(s)
Persona de Mediana Edad , Humanos , Masculino , Sarcoma de Ewing/diagnóstico , Neoplasias Nasales/diagnóstico , Sarcoma de Ewing/complicaciones , Neoplasias del Seno Maxilar/complicaciones , Neoplasias Nasales/complicaciones , Enfermedades Raras/diagnóstico , Obstrucción Nasal/etiología , Mucosa Nasal/patología , Tomografía Computarizada por Rayos XAsunto(s)
Neoplasias Nasales/diagnóstico , Sarcoma de Ewing/diagnóstico , Resultado Fatal , Humanos , Masculino , Neoplasias del Seno Maxilar/complicaciones , Persona de Mediana Edad , Mucosa Nasal/patología , Obstrucción Nasal/etiología , Neoplasias Nasales/complicaciones , Enfermedades Raras/complicaciones , Enfermedades Raras/diagnóstico , Sarcoma de Ewing/complicaciones , Tomografía Computarizada por Rayos XRESUMEN
Haemangiomas are benign fibrovascular tumours relatively that are common in the head and neck, where 60% of them occur Among the various categories of haemangiomas, lobular capillary haemangiomas (LCH) occur frequently on the skin, lips, buccal mucosa, tongue and gingiva. However, they are vanishingly rare in the paranasal sinuses. The imaging features of LCH are non-specific. The histological characteristics of LCH can also make diagnosis difficult as sometimes resemble highly vascular malignant tumours. This leads to the false preoperative diagnosis of suspected malignancy in many cases, which places the patient under unnecessary distress and anxiety. We present a case of LCH appearing as a suspicious nasal lesion of the lateral nasal wall with unilateral nasal obstruction, necrotic centre and epistaxis. The tumour was excised endoscopically in one operation including endoscopic medial maxillectomy. Further education about this lesion is deemed important as preoperative embolisation may be needed for a safe operation.
Asunto(s)
Hemangioma Capilar/diagnóstico , Neoplasias del Seno Maxilar/diagnóstico , Neoplasias Nasales/diagnóstico , Anciano , Epistaxis/etiología , Femenino , Hemangioma Capilar/complicaciones , Hemangioma Capilar/cirugía , Humanos , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/cirugía , Obstrucción Nasal/etiología , Neoplasias Nasales/complicaciones , Neoplasias Nasales/cirugíaAsunto(s)
Hemangioma/complicaciones , Hemangioma/diagnóstico , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/diagnóstico , Obstrucción Nasal/etiología , Hemangioma/irrigación sanguínea , Hemangioma/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Arteria Maxilar/diagnóstico por imagen , Arteria Maxilar/patología , Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/irrigación sanguínea , Neoplasias del Seno Maxilar/diagnóstico por imagen , Radiografía , Adulto JovenRESUMEN
The case of a recurrent phosphaturic mesenchymal tumour of the maxillary sinus 10 years after the first surgical excision is reported. The neoplasm first presented with paraneoplastic osteomalacia causing a pathological femur fracture. A right maxillary sinus tumour was identified and treated thereafter. The patient had no local symptoms and serum electrolytes returned to normal after surgical removal of the tumour. However, 10 years later, the patient's urine Ca and P levels increased and an octreoscan detected a new tumour in the right maxillary sinus. Early diagnosis prevented the effects of the paraneoplastic activity of the neoplasm. This case emphasises the importance of specific, close follow-up, because the neoplasm rarely produces local signs indicating its position. To our knowledge, this is the first reported case of a late relapse presenting without relevant symptoms (local pain or swelling or pathological fractures).