[Temporal bone chondroblastoma. A clinical case and literature review]. / Condroblastoma de hueso temporal. Caso clínico y revisión de la literatura.

We report a clinical case of a 31 year old male with a left temporal painful mass of six months evolution. After radiologic diagnosis, intraoperatory biopsy and surgical removal, the anatomopathological result confirmed the histology of chondroblatoma, with a satisfactory postoperative evolution. The chondroblastoma is a benign bone tumor typically located in the epiphysis of long bones and the temporal bone is an excepcional location as we have verified through a literature review.

Condroblastoma de hueso temporal. Caso clínico y revisión de la literatura / Temporal bone chondroblastoma. A clinical case and literature review

Presentamos el caso clínico de un paciente de 31 años de edad que consulta por una tumoración dolorosa en región temporal izquierda de seis meses de evolución. Tras su examen radiológico, biopsia intraoperatoria y exéresis quirúrgica se confirma el diagnóstico de condroblastoma, con una evolución clínica postoperatoria satisfactoria. El condroblastoma es un tumor benigno que asienta preferentemente en las epífisis de los huesos largos de las extremidades, cuya localización en hueso temporal es excepcional como constatamos al realizar una revisión bibliográfica de esta patología

We report a clinical case of a 31 year old male with a left temporal painful mass of six months evolution. After radiologic diagnosis, intraoperatory biopsy and surgical removal, the anatomopathological result confirmed the histology of chondroblatoma, with a satisfactory postoperative evolution. The chondroblastoma is a benign bone tumor typically located in the epiphysis of long bones and the temporal bone is an excepcional location as we have verified through a literature review

[Cancer of the parotid gland]. / Tumores malignos de la glándula parótida.

OBJECTIVE: To review our experience and results in the diagnosis and treatment of a low incidence pathology such as the cancer of the parotid gland. METHODS: The study reviewed 40 patients with malignant tumors of the parotid gland treated between 1991 and 2002 in our hospital. It was used the staging system TNM (American Joint Committee on Cancer 1997). RESULTS: The most common histological type in our series is the squamous cell carcinoma, in general unilateral and in the superficial lobe. Rapid tumor enlargement, fixation to the skin, cervical lymphadenopathy, pain and facial palsy are malignancy clinical findings. We obtained a 56% 5-year global survival rate, with a 68% for stages I and II, and 43% for stages III and IV. CONCLUSIONS: This pathology has a low incidence but high mortality. The staging and histological type are important prognostic factors. The surgery is the election treatment, associated with neck disection or radiotherapy.

Tumores malignos de la glándula parótida / Cancer of the parotid gland

Objetivo: Revisar la experiencia y resultados de nuestro hospital en el diagnóstico y tratamiento de una patología con una baja incidencia como son los tumores malignos de la glándula parótida. Material y método: Realizamos un estudio retrospectivo de 40 pacientes tratados de tumores malignos de la glándula parotídea entre los años 1991 y 2002 en nuestro hospital. El sistema de estadiaje utilizado fue el TNM, según la clasificación de la American Joint Committee on Cancer (1997). Resultados: El tipo histológico más frecuente en nuestra serie es el carcinoma epidermoide, presentándose generalmente como una tumoración unilateral y en el 90% de los casos en el lóbulo superficial de la glándula. La presencia de un crecimiento rápido, dureza y fijación a los elementos adyacentes y la piel, adenopatías regionales, dolor o parálisis facial están íntimamente relacionados con el grado de malignidad. La supervivencia global de los tumores malignos de parótida en nuestro estudio fue del 56% a los 5 años, con un 68% para los tumores en estadio I y II y un 43% para los de estadio III y IV. Conclusiones: Esta patología tiene una incidencia baja, pero de alta mortalidad. La histología y el estadio tienen un importante valor pronóstico. La cirugía es el tratamiento de elección, con vaciamiento cervical o radioterapia complementaria

Objective: To review our experience and results in the diagnosis and treatment of a low incidence pathology such as the cancer of the parotid gland. Methods: The study reviewed 40 patients with malignant tumors of the parotid gland treated between 1991 and 2002 in our hospital. It was used the staging system TNM (American Joint Committee on Cancer 1997). Results: The most common histological type in our series is the squamous cell carcinoma, in general unilateral and in the superficial lobe. Rapid tumor enlargement, fixation to the skin, cervical lymphadenopathy, pain and facial palsy are malignancy clinical findings. We obtained a 56% 5-year global survival rate, with a 68% for stages I and II, and 43% for stages III and IV. Conclusions: This pathology has a low incidence but high mortality. The staging and histological type are important prognostic factors. The surgery is the election treatment, associated with neck disection or radiotherapy

[Geniculate ganglion tumors. Therapeutic and reconstructive management]. / Tumores del ganglio geniculado. Manejo terapéutico y reconstructivo.

We present five cases of patients diagnosed of a facial nerve tumoral lesion localised at the Geniculate Ganglion and all of which underwent surgical resection. The initial symptoms were in four cases of peripheral facial nerve paralysis and in the fifth case facial paresis. Two trans-mastoid extralabyrinthine approaches were performed and one through a combined path (middle fossa and trans-mastoid) with reconstruction of the facial nerve through a termino-terminal graft. In the fourth case, an approach through fossa media was done, and did not include nerve reconstruction but palliative treatment with a palpebral gold plaque. In the fifth case, a modified trans-labyrinthine approach with facial-hypoglossus termino-terminal anastomosis. Histological diagnosis was 3 neurinomas and 2 hemangiomas. Of the termino-terminal grafts two managed a functional Grade III of the House-Brackmann classification. The third one sustained a Grade VI and therefore a suspension with temporal muscle was carried out. The patient with facial-hypoglossus anastomosis is in a functional Grade IV. Geniculate ganglion tumors are in their majority benign and their treatment is the total resection of the tumor. Nerve reconstruction can be primary or deferred with the aid of a nerve graft or anastomosis, being necessary palliative techniques when resection is not possible.

Tumores del ganglio geniculado. Manejo terapéutico y reconstructivo / Geniculate ganglion tumors. Therapeutic and reconstructive management

Presentamos cinco casos de pacientes diagnosticados de una lesión tumoral del nervio facial localizada en la región del ganglio geniculado a los cuales se practicó cirugía de exéresis. La clínica inicial fue en cuatro de los casos parálisis facial periférica de larga evolución y en el quinto paresia facial. Se realizaron dos abordajes transmastoideos extralaberínticos y uno por vía combinada (fosa media y transmastoidea) con reconstrucción del nervio facial mediante injerto termino-terminal. En el cuarto caso, un abordaje por fosa media, no se incluyó reconstrucción nerviosa sino tratamiento paliativo con placa de oro palpebral. En el quinto, un abordaje translaberíntico modificado, se hizo anastomosis termino-lateral hipogloso-facial. El diagnóstico histológico fue de 3 neurinomas y 2 hemangiomas. Funcionalmente 2 de los injertos termino-terminales lograron grado III de la clasificación de House-Brackmann. El tercero mantuvo grado VI por lo que se realizó suspensión con músculo temporal. El paciente con anastomosis hipoglosofacial está en grado funcional IV. Los tumores del ganglio geniculado son en su mayoría de histología benigna y su tratamiento es la exéresis completa. La reconstrucción nerviosa puede ser primaria o diferida ayudándose de injerto nervioso o anastomosis, siendo necesarias las técnicas paliativas cuando ésta no es posible (AU)

We present five cases of patients diagnosed of a facial nerve tumoral lesion localised at the Geniculate Ganglion and all of which underwent surgical resection. The initial symptoms were in four cases of peripheral facial nerve paralysis and in the fifth case facial paresis. Two trans-mastoid extralabyrinthine approaches were performed and one through a combined path (middle fossa and trans-mastoid) with reconstruction of the facial nerve through a termino-terminal graft. In the fourth case, an approach through fossa media was done, and did not include nerve reconstruction but palliative treatment with a palpebral gold plaque. In the fifth case, a modified trans-labyrinthine approach with facial-hypoglossus termino-terminal anastomosis. Histological diagnosis was 3 neurinomas and 2 hemangiomas. Of the termino-terminal grafts two managed a functional Grade III of the House-Brackmann classification. The third one sustained a Grade VI and therefore a suspension with temporal muscle was carried out. The patient with facial-hypoglossus anastomosis is in a functional Grade IV. Geniculate ganglion tumors are in their majority benign and their treatment is the total resection of the tumor. Nerve reconstruction can be primary or deferred with the aid of a nerve graft or anastomosis, being necessary palliative techniques when resection is not possible (AU)