AIDS-related sinonasal Burkitt lymphoma successfully treated with intensive chemotherapy regimen and high active antiretroviral therapy.

Burkitt lymphoma (BL) is the second most common AIDS-related lymphoma. Primary sinonasal BL in HIV patients is extremely rare and treatment data in this subset of patients is almost nonexistent. Recently, a few studies reported promising results treating HIV-associate BL with an intensive chemotherapy regimen. The use of highly active antiretroviral therapy (HAARTHAART) concomitantly with chemotherapy seems to improve patient outcomes, but this topic is still controversial due to potential drug interactions. We report a case of a 29-year old woman diagnosed with AIDS presenting with symptoms of chronic sinusitis. Subsequent investigation by CT scan and endoscopic biopsy discovered a sinonasal BL in an early stage. The patient was treated with intensive chemotherapy and HAARTHAART and achieved a complete remission and long-term immunologic recovery. This case report describes a rare entity whose natural history, treatment and prognosis is infrequently characterized in the medical literature.

Cánceres de cavidades paranasales / Paranasal sinuses cancers

Los cánceres de la cavidad nasal y de las cavidades paranasales (CPN) son neoplasias infrecuentes y de una gran variedad histológica. La complejidad de las estructuras vitales circundantes hacen que la cirugía radical y la radioterapia se asocien a complicaciones. Publicaciones recientes sobre el tema han demostrado una mejoría progresiva tanto de los métodos terapéuticos como de los resultados postratamiento. Repasamos los tipos de neoplasias que ocurren en las CPN y se discuten las opciones de tratamiento actuales, incluyendo las técnicas quirúrgicas y la terapia multimodal. Las neoplasias de CPN son complejas de tratar debido a las características anatómicas de la región y a la variedad de cánceres que ocurren en esta área. Actualmente el gold standard es la cirugía, abierta o endoscópica, combinada con radioterapia adyuvante. Las complicaciones potenciales incluyen cefalorraquia, meningitis, la formación de abscesos, ceguera, entre otros. Para mejorar la sobrevida de los pacientes con cáncer, debemos centrarnos en el diagnóstico precoz y preciso, así como en la búsqueda de tratamientos más eficaces, con los menores efectos adversos.

Cancers of the nasal cavity and paranasal sinuses are infrequent and of a great variety of histological types. The complexity of the surrounding vital structures render radical surgery and radiation therapy delicate and associated with numerous complications. Recent papers on nasal and paranasal sinuses carcinomas have shown a progressive improvement of treatments and results. Here we review paranasal sinuses tumor types and discuss current treatment options, including surgical techniques and polimodal therapy. Paranasal sinuses treatment is complex, because of the anatomic details of the region and the variety of cancers found in this area. At present, the gold standard is open or transnasal surgery, combined with adjuvant radiation therapy. Potential complications include cerebrospinal fluid leakage, meningitis, abscess formation and blindness, among others. in order to improve the survival of cancer patients, we should focus on early and accurate diagnosis as well as in the search for more effective treatments that minimize undesired side effects.

T-cell sinonasal lymphoma presenting as acute orbit with extraocular muscle infiltration.

We describe a rare case of sinonasal T-cell lymphoma in an 11-year-old boy who presented with a right acute orbit characterized by proptosis, eyelid edema and erythema, limitation of eye movements, and excruciating pain on the right side of his face. Orbital computed tomography showed progressive right extraocular muscle enlargement. One biopsy specimen showed extensive tissue necrosis and an infiltrate of atypical cells with pleomorphic nuclei within the walls of blood vessels. Immunohistochemical studies demonstrated that these cells were positive for leucocyte common antigen (CD45), CD3 cytoplasmic, CD45RO, and terminal deoxynucleotidyl transferase and negative for CD20, CD57, CD56, CD99 and Epstein-Barr virus. Chemotherapy for T-cell non-Hodgkin lymphoma was initiated, but the patient's status deteriorated and the child died of respiratory insufficiency, sepsis, and central nervous system infection.