[Primary extramedullary plasmacytomas of the upper respiratory tract. A study of four cases with infrequent localization]. / Plasmocitomas primarios de vías aerodigestivas altas. A propósito de cuatro casos.

OBJECTIVE: Assessment of the incidence, diagnosis and treatment of three patients afflicted of extramedullary plasmacytoma located in the Waldeyer's ring, and one case afflicted of maxillary sinus disease. PATIENTS: The localization of the masses was the palatine amygdala in two cases, and the rhinopharynx and maxillary sinus in the remaining two patients. Major symptoms were dysphagia respiratory failure with closed rhinolalia, and headache. Diagnosis was made by histological study of biopsied tissue. In every case, general illness or other site of localization were ruled out. RESULTS: In our casuistic, the incidence of primary extramedullary plasmacytoma in Waldeyer's ring is 1.2%. The patient's age were 45, 50, 62, and 73 years respectively, and the male/female ratio was 1. In those cases located in the tonsils, a bilateral tonsillectomy was performed. In the case located at the maxillary sinus, a sinus trepanation was performed according the Caldwell-Luc's technique, followed by local radiotherapy at doses of 40 Gy. In the case located at the rhinopharynx, radiotherapy was the only choice. These three different therapeutical procedures led to the disappearance of the disease, and, after a 12 to 53 month-period, patients remain asymptomatic. A patient died due to other causes not related to the illness.

[Hypernephroma metastasis in frontal sinus]. / Metástasis de hipernefroma en seno frontal.

PURPOSE: We present a case of metastatic neoplasia in the right frontal sinus derived from and hypernephroma, with a clinical picture that initially was interpreted as a mucocele. PATIENTS AND METHODS: Sixty years old male. Personal history: prostatectomy and left nephrectomy because of hypernephroma three years before. In december 92 the patient reported a protrusion in the right frontal sinus. CT scans and NMR revealed a breakage of the external and internal walls of the right frontal sinus and the right orbital roof. In february 93 a surgical exploration of the frontal sinus revealed the metastatic nature of the lesion. DISCUSSION: Metastatic tumors in paranasal sinuses are infrequent since most of the tumors in this localization are primary. Metastatic affectation of the frontal sinus is extremely rare. We recommend the systematic exploration of paranasal sinuses in patients affected by hypernephroma.

[Malignant tumor of the external auditory canal]. / Tumoración maligna de conducto auditivo externo.

The neoplasms from the modified apocrine glands of the external auditory canal are usually included under the term ceruminoma without any reference to their histology, clinical course or prognosis. It seems better to classify them according to their histologic pattern in the following types: 1.--Ceruminous adenoma, 2.--Adenoid-cystic carcinoma, 3.--Adenocarcinoma, and 4.--Pleomorphic adenoma (mixed tumour). We describe a case of adenoid-cystic carcinoma originated at postero-superior wall of the external auditory canal which presented as an otitis of long duration, and was treated surgically and received post-operative radiotherapy. The patient is at present free of disease. We review the literature on this group of tumours of the EAC.