Soft tissues sarcomas of the head and neck in adult: histo-clinical analysis of 30-years material in the data of ENT Department of Silesian Medical University.

AIM: The aim of this study was the assessment of efficiency treatment of soft tissues sarcomas in adult in the data of ENT Department of Silesian Medical University in Katowice. MATERIAL AND METHODS: Retrospective analysis has been carried out for 22 patients with the diagnosis of STS in head and neck, treated in the ENT Department of the Silesian Medical University in Katowice, Poland, in the years 1980-2010. Most common histopathological diagnosis was fibrosarcoma. Preferred treatment was surgery combined with radiotherapy. Despite intensive treatment results remain unsatisfactory. RESULTS: The most frequent cause of treatment failure was local recurrence, which was found in 7 cases. In 2 patients, nodal recurrence occurred, while in further 4 patients dissemination of neoplasm occurred. Of the 22 patients in our study, 13 died. Complete 5-year survival in the study group was achieved in case of 3 patients, 4 other patients have survived up to 3 years so far, while 1 patient survived less than 1 year so far. CONCLUSIONS: The application of surgical treatment combined with post-surgical radiotherapy allowed to enhance life quality and to prolong the life of patients. Unfortunately, the percentage of local recurrence cases still remains high. Results of STS treatment are still not satisfactory. The main reasons for it include late for treatment, in relation to the moment of noticing the tumor, in the majority of cases a high malignancy level, as well as technically difficult procedures, along with the strong tendency for local recurrence.

Intraorbital foreign bodies--5 own cases and review of literature.

Five patients were surgically treated for intraorbital foreign body: a 14-year-old girl had a door glass splinter, a 23-year-old man a metallic foreign body--gunshot pellet, a 55-year-old man a splinter from a metallic bar, a 48-year-old patient the splinters of circular saw and 61-year-old man with shot. Two foreign bodies were removed using the Krönlein-Reese-Berk lateral orbitotomy, two others by Sewell medial orbitotomy and one with superior orbitotomy of Dandy-Naffziger. Radiographs and CT scans were used to identify and localize intraorbital foreign bodies. In one case we found coexistence foreign body (shot) and tumor--inflammation pseudotumor of the orbita. It is possible, that in this case long-time occupy foreign body in the orbita was a cause of that tumor. All foreign bodies were successfully removed, and postoperative course was uneventful. The Krönlein-Reese-Berk orbitotomy provides a satisfactory access to the lateral and posterior orbit, which is of particular importance in the case of a deeply penetrating foreign body (metallic or glass). Surgical removal of intraorbital foreign bodies is a classic example of an interdisciplinary therapeutic approach. Best outcome is usually a result of a team of an ophtalmologist, ENT surgeon, maxillary surgeon and possibly also neurosurgeon performing the operation.

[Head and neck phlegmons - diagnosis and treatment - own observations]. / Ropowice glowy i szyi - diagnostyka i leczenie - obserwacje wlasne.

INTRODUCTION: Head and neck phlegmons are rare diseases, however they are associated with high risk of mortality. They can derive from different structures of the described anatomical area. They are often odontogenic. Imaging studies, especially computerized tomography play the greatest role in diagnosis of phlegmons. The treatment is based on surgical incision and drainage as well as analgesia. MATERIALS AND METHODS: A retrospective analysis was conducted on 11 patients from three different ENT centers: ENT Department of the Medical University of Silesia in Katowice, ENT Department of the Municipal Hospital in Sosnowiec and ENT Department of the Hospital No.1 in Bytom. Laboratory results, imaging results, treatment and other factors influencing the course of the disease were analyzed. RESULTS: Most patients were males and the average age was 50.8. In most cases the phlegmons were diffused and localized in different regions of head and neck. The phlegmons were mainly located in the carotid and parapharyngeal space. Streptococci and staphylococci were the most common pathogenes found in the examined material. Antibiotics and metronidasol were effective in all cases. Two types of surgical procedure were performed - either common abscess incision or broad incision along sternocleiodomastoid muscle. CONCLUSIONS: Head and neck phlegmons are rare and they affect patients at any age. The dominating localization of the phlegmons depends mainly on the starting point. Computerized tomography plays the most important role in diagnosis. The treatment is based on surgical procedures and antibiotics.

[Head and neck tuberculosis - still current problem in ENT practice]. / Gruzlica narzadów glowy i szyi - wciaz aktualny problem w praktyce laryngologicznej.

INTRODUCTION: It is estimated that between XVI and XIX century one fourth of European population died of tuberculosis. Nowadays tuberculosis is still one of the most important infectious diseases. In 2009 estimately 9 million new cases were registered worldwide, mortality due tuberculosis reached 1.5 million. In Poland extrapulmonary tuberculosis is rare (7% of overall morbidity) and most commonly affects pleura, lymph nodes, bones, joints and genitourinary system. Head and neck tuberculosis is rare and causes many diagnostics problems. METHODS: Retrospective analysis of case histories of patients admitted to ENT Department of Silesian Medical University in Katowice. RESULTS: Between 1993 and 2010 four cases of head and neck tuberculosis were diagnosed in our Clinic. Two of patients were admitted to the hospital with symptoms of laryngeal tumor such as difficulty in swallowing. During direct laryngoscopy tissue specimens were taken. Examination of the third patient showed tumor located below left angle of mandibule. During superficial parotidectomy tumor was removed. In the fourth registered case tuberculosis manifested as tumor of nasopharynx. In every case which is mentioned above pathology reports revealed epithelioid cell granulomas with caseous necrosis typical for tuberculosis. Patients underwent tuberculostatic treatment. CONCLUSION: Rare occurrence and lack of characteristic symptoms of head and neck tuberculosis often lead to misdiagnosis. Histopathological examination is the most important diagnostic procedure. Microbiological examination is difficult in extrapulmonary tuberculosis, because of low concentration of pathogens in specimens. Tuberculostatic therapy is the leading method of treatment in every case of tuberculosis.

[Küttner's tumor (chronic sclerosing sialadenitis) - a rare cause of submandibular gland enlargement]. / Guz Küttnera (chronic sclerosing sialadenitis) - rzadka przyczyna powiekszenia slinianki podzuchwowej.

Küttner's tumor is a benign tumour-like lesion of the salivary glands. Predominantly affects the submandibular gland. It is also known as chronic sclerosing sialoadenitis or cirrhosis of submandibular gland. This is an underrecognized entity in the surgical pathology and cytology literature. Most patients experience recurrent pain, discharge and swelling that is often associated with eating, but others only have asymptomatic hard swelling of the submandibular gland. Histologic examination of the excised submandibular glands revealed preserved lobular architecture, thickening of interlobular septa by sclerotic tissue, dense lymphoplasmacytic infiltrate, preservation of ducts with periductal fibrosis, and variable loss of acini. The morphologic appearance, in conjunction with the elevated IgG4 expression, distinguishes chronic sclerosing sialadenitis from other inflammatory diseases of the salivary glands. Chronic sclerosing sialadenitis belongs to the spectrum of IgG4-related diseases. We present a case of Küttner's tumor in a 62-year-old female treated by surgery. Although this disease was first described by Küttner in 1896, this clinical entity which masquerades as carcinoma is underdiagnosed by many surgeons. There is not enough evidence to support any diagnostic means that could help in the differential diagnosis of this benign condition. Given the high rate of malignancy in firm, painless lesions of the submandibular gland, surgical excision is often advocated and Küttner's tumor is usually diagnosed by the histopathologist.

Assessment of vestibulocochlear organ function in patients meeting radiologic criteria of vascular compression syndrome of vestibulocochlear nerve--diagnosis of disabling positional vertigo.

BACKGROUND: This study sought to assess the vestibulo-cochlear organ in patients meeting radiologic criteria of vascular compression syndrome (VCS) of the eighth cranial nerve. MATERIAL/METHODS: The authors performed a retrospective analysis of 34 patients (18 women, 16 men; mean age, 49 years) treated in between 2000 and 2007, with VCS of the eighth cranial nerve by MRI. Contrasted magnetic resonance imaging identified an anterior inferior cerebellar artery vascular loop adhering to the vestibule-cochlear nerve in all 34 cases. All patients were given pure tone audiometry, distortion product otoacoustic emissions, auditory brainstem response, and electroneurographic examinations. RESULTS: Most-common symptoms were unilateral hearing loss (82%), unilateral tinnitus (80%), and dizziness (74%). Most-frequent abnormalities in performed examinations were specific auditory brainstem response changes (interpreted according to Möller's criteria) in 86% of cases and sensorineural hearing loss in pure tone audiometry (82%). Abnormal changes in electronystagmography were found in the absence (12%) or weakness (35%) of a caloric response. No patients were surgically treated. CONCLUSIONS: Significantly, there is no more weakness or absence of the caloric response of a vestibular organ in a patient with vascular compression of the vestibulo-cochlear nerve. Despite an absence of electrophysiologic testing of vestibular organ dysfunction, most examined patients (meeting the radiologic criteria of VCS of the eighth cranial nerve) had subjective symptoms like vertigo and dizziness. Disabling positional vertigo should be considered in the differential diagnosis of vertigo when accompanied by tinnitus or deafness.

Transcriptional activities of histone H3, cyclin D1 and claudin 7 encoding genes in laryngeal cancer.

Uncontrolled proliferation and a decrease in cell-cell adhesion are one of the most important characteristics of malignancy. Determination of replication-dependent histone H3 can be applied as a proliferative marker. Cyclin D1 (CCND1) regulates the cell cycle by participating in the control of the G1/S phase transition. Claudins (CLDN) are components of tight junctions and may play an essential role in the loss of tissue cohesion. The aim of the study was to assess the mRNA expression of histone H3, cyclin D1, and claudin 7 genes in laryngeal squamous cell carcinoma (LSCC) and adjacent nonneoplastic tissues. The study group consisted of 32 patients with LSCC. Adjacent nonneoplastic tissues of incision lines were used as controls. Quantification of H3, CCND1 and CLDN7 mRNAs was performed by the use of real-time QRT-PCR assay. Molecular analysis showed a significantly higher expression of CCND1 (P = 0.0001; Wilcoxon test) and H3 (P = 0.0141) genes in tumor tissues than in surrounding nonneoplastic tissues. On the contrary, transcriptional activity of claudin 7 gene was higher in histologically normal tissues; however, this difference was not statistically significant (P = 0.1499). The data obtained indicate that laryngeal cancer is characterized by high proliferative potential mediated by increase in cyclin D1 and H3 mRNAs expression.

[16 years of experience in laryngeal microsurgery with use laser CO2: cooperation between laryngologist and anesthesiologist - in material of ENT Department of Silesian Medical University]. / 16 lat doswiadczen w mikrochirurgii krtani z uzyciem lasera CO2: aspekt wspólpracy anestezjologa i laryngologa - w materiale Katedry i Kliniki Laryngologii SUM w Katowicach.

UNLABELLED: Laryngeal microsurgery is currently the primary method of treatment of many diseases of the larynx. Breakthrough for the development of laryngeal microsurgery was the introduction of laser technology. The laryngeal microsurgery is used mainly laser CO2. Endoscopic laryngeal microsurgery using the laser poses a unique challenge to the anesthesiologist, ensuring safe conditions of anesthesia, the patient and simultaneously appropriate operating conditions for the surgeon for precisely perform the procedure. MATERIAL AND METHODS: Between 1995 and 2010 carried out in the Department of Otolaryngology SUM 832 microsurgical operations of the larynx using a CO2 laser. CONCLUSION: The perioperative management and close cooperation with the surgeon and anesthesiologist are essential for safe and efficient conduct of the operation the larynx using a microsurgical CO2 laser.

The assessment of hearing organ of school children in Upper Silesia region.

Because at present no estimated data is available concerning the frequency of hearing loss in the population of primary school children in Silesia, it has been assumed useful to carry out a research programme. An important advantage of this study is the assessment of hearing in children from Upper Silesian region, a top ranking region in Europe in industrialisation and environmental pollution. In the selected population of primary school children in the province of Silesia, hearing loss occurred in 6% of the examined pupils; in schools located in urban areas it was higher than in schools from rural areas. In the group of children aged 6-10 years conductive hearing loss occurred significantly more frequently, than main cause of that hearing loss was Eustachian tube dysfunction. The obtained results testify about the society being hardly aware of the problems related to hearing loss, which stresses the necessity of conducting screening examinations of hearing organ in children at school age, as well as improving the health care and prevention in that respect.

[Chondrosarcomas of the larynx and sinus maxillaris--review of literature and report of three cases]. / Chrzestniakomiesaki krtani i zatoki szczekowej - przeglad literatury i opis trzech przypadków.

Chondrosarcoma is a very rare neoplasm in the head and neck region. This region is associated with favourable prognosis. Only 340 cases of chondrosarcoma of the larynx and nearly 300 of sinus maxillaris have been reported in this localization. The most reasonable treatment is radical surgery. Radiotherapy and chemotherapy are of little value. Without metastasis the long term prognosis is excellent. Clinical, pathologic and radiologic characterities of these tumors are described and review of the literature is presented. The authors present two cases chondrosarcoma of the larynx and one case chondrosarcoma of sinus maxillaries.

Metal-proteinase ADAM12, kinesin 14 and checkpoint suppressor 1 as new molecular markers of laryngeal carcinoma.

The assessment of gene expression profile in laryngeal cancer allows implementation of molecular biology methods in diagnostics, as well as in prognosticating the course of disease, thus allowing taking most optimal decisions as regards the method of treatment, scope of surgical procedure, or the necessity of adding complementary radiotherapy. The aim of the project was to analyze the gene expression profile in laryngeal cancer using oligonucleotide microarrays, having in mind searching new molecular markers for that carcinoma. The study comprised a group of 43 patients (38 males and 5 females) suffering from squamous cell laryngeal carcinoma, diagnosed and surgically treated in the years 2005-2007 in the ENT Department of the Silesian Medical University in Katowice, Poland. RNA was isolated from frozen tissue fragments, with the use of columns RNeasy Midi and Mini Kit (Qiagen). For the examination of gene expression profile, oligonucleotide microarrays of high density were used, provided by Affymetrix (U 133 2.0 PLUS) containing over 54,000 probes for over 47,000 transcripts. Four genes previously not examined in that respect in laryngeal carcinoma, occurred to be good markers of the neoplasm. They are: metal-proteinase ADAM12, cyclin-dependent kinase 2-CDK2, kinesin 14-KIF14, suppressor 1 of checkpoint-CHES1. The analysis of gene expression profile allows, in laryngeal carcinoma, to point out to new genes, which in future may become molecular markers of the carcinoma.

[Magnetic resonance tractography in neuroradiological diagnostic aspects]. / Traktografia rezonansu magnetycznego w diagnostyce neuroradiologicznej.

Diffusion tensor imaging is unique in its ability to non-invasively visualize white matter fiber tracts in the human brain in vivo. White matter fiber bundles of the human brain form a spatial defined by the anatomical and functional architecture. Determination of axonal pathways provides an invaluable means to study the connectivity of human brain and its functional network. Comparison of fiber tract properties across subjects requires comparison at corresponding anatomical locations. In this paper, we present application of white matter tractography method based on incoherent motion of water molecules in fiber tissue, mainly in central nervous system. This motion is itself dependent on the micro-structural environment that restricts the movement of the water molecules. In white matter fibers there is a pronounced directional dependence on diffusion. With white matter fiber tracking or tractography, projections among brain regions can be detected in the three-dimentional diffusion tensor dataset according to the directionality of the fibers. The authors indicate diagnostic possibilities of MR tractography in otolaryngology for imaging the nervous tracts of sense of hearing, smell and taste with particular consideration of otoneurological evaluation of patients with cochlear implants and bone anchored hearing aid (BAHA). White matter tracts can be evaluated independently by using diffusion tensor tractography, which appears to be a promising technique for determining changes in white matter in degenerative disease. The authors also indicate that method as a beneficial in the surgical planning for patients with intrinsic brain tumors.

Transforming growth factor beta isoforms (TGF-beta1, TGF-beta2, TGF-beta3) messenger RNA expression in laryngeal cancer.

PURPOSE: Cancerogenesis is a multistage process controlled by many cytokines, including growth factors. The aim of the study was the comparison of transcriptional activity of transforming growth factor beta (TGF-beta) genes in laryngeal squamous cell carcinomas and adjacent nonneoplastic tissues. MATERIALS AND METHODS: Tissues samples were obtained from 32 patients with laryngeal squamous cell carcinoma in histologic grades G1 to G3 who underwent surgical treatment at the ENT Clinics of Medical University of Silesia in Katowice, Poland. Quantification of gene expression was performed by real-time quantitative reverse transcriptase polymerase chain reaction technique. RESULTS: In tumor cells, expression of TGF-beta1 and TGF-beta2 isoforms (P < .001) was higher than in normal tissues. There was a positive correlation between the expression of TGF-beta1 and TGF-beta2 genes in tumors (R = 0.78, P = .0000) and adjacent normal tissues (R = 0.77, P = .0000). CONCLUSIONS: The results suggest that TGF-beta1 and TGF-beta2 messenger RNAs may be useful as molecular markers in distinguishing cancer from nonneoplastic tissues in laryngeal area.

[The results of hearing screening in selected population of primary schoolchildren in Silesia]. / Wyniki badan przesiewowych sluchu u wybranej populacji dzieci szkól podstawowych na Slasku.

The aim of this study was analysis of results of audiologic evaluation in the group of 191 children with hearing loss. Children were selected from the group of 8885 pupils of primary schools in Silesia by screening test "Slysze" in 2002. Universal Screening Program of Hearing in Children and Teenage "Slysze" was created and introduced in to the clinic practice by Institute of Physiology and Pathology of Hearing in Warsaw in 1999. The screening program consists of: pure tone examination and speech audiometry in noise. Children with hearing loss detected by this test in 2002 were followed laryngological and audiological examination. Special attention was paid on articulation disturbances, communicational and educational problems in children with hearing loss. The authors focused also attention on "discreet signs of hearing deficiency" (not reacting to commands, turning up a TV-set, loud speech). The validation of screening test "Slysze" was also conducted. In the selected population of primary schoolchildren in Silesia hypoacusis occurred in 6% of examined children, in "city" schools the percentage proved to be higher than in "village" schools. In the group aged 6 to 10 the conductive hearing loss occurred considerable more frequently. Eustachian tube dysfunctions in children with conductive hearing loss occurred more frequently in the group of the younger ones. Older than 10 years old in most cases proved to have perceptive-type of hearing loss. The hearing loss hinders a child's psycho-intellectual development, it is important to detect it as early as possible. The evaluations showed that despite frequent occurrence of "discreet symptoms of hypoacusis", only 17.8% of parents suspected hearing loss in their own child. According to the frequency of parents' signals of "discreet symptoms of hypoacusis" it was found that the fact of turning up TV sound was the most powerful sign indicating the probability of hearing loss (45.5%). The most common risk factors of hearing loss in schoolchildren were also estimated. A characteristic, homogenous group of 34 children (17.8%) was the group with MSHL minimal sensorineral hearing loss of high frequencies (6-8 kHz). Results obtained give evidence of low level of awareness in the society concerning the problem of hypoacusis, which confirms the necessity to screening of hearing in schoolchildren and improving of health care in this respect. Diagnosing hypoacusis in case of children is an interdisciplinary problem, requiring cooperation of medical circles but also teachers, speech therapists and parents.

[The stapedius muscle--the present opinions about anatomy and physiology]. / Miesien strzemiaczkowy - aktualne poglady na temat anatomii i fizjologii.

The authors present current opinions about anatomy and physiology of the stapedius muscle and its role of the hearing process. The stapedius muscle is the smallest striped muscle of the human body and contracts reflexive in response to acoustic stimulation. The stapedius muscle puls the neck of the stapes in the direction of the stapedius tendon. This movement causes stiffening of the incus and the malleus and also changes the pressure of the perilymph in the inner ear. This is the protective inner ear action of the stapedius reflex against hearing damage by noise. The stapedius reflex shows bilateral interactions and its center is located in the brainstem. The binaural interaction of the stapedius reflex plays an important role in the maintaining of the sound direction. The stapedius tendon also plays role in the vascularization of the long process of the incus.

[Long-term results after argon plasma coagulation (APC) inferior turbinates reduction]. / Wyniki odlegle konchoplastyki z uzyciem plazmy argonowej (APC).

Interior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvements. In these cases, surgical reduction of inferior turbinates can be proposed. Authors analyzed long-term results of argon plasma coagulation (APC) for inferior turbinates reduction in patients with chronic nasal obstruction. Rhinomanometric parameters, clearance of saccharine test results and cytological examination were statistically analyzed in 70 patients after 3 month and in 47 after 12 month after surgery. Five patients received a second operation. Only patients with first degree in T/S (turbinate/septum) nasal septum deviation were enrolled in both groups. Every patients were treated ineffectively with nasal drops. All patients received topical anesthesia. The procedure of APC were easy to perform end we did not experience postoperative bleeding. Rhinomanometric measurement demonstrated a significant nasal flow at 3 and 12 month after APC. Before 3 and 12 month after surgery the values for resistance shoved significant difference. There were no changes in saccharine transit - time during the follow-up period. At 3 postoperative month, the nasal stuffiness had improved 62 (88%) patients. At 12 month after surgery, the nasal stuffines had improved 34 (73%) patients. APC was shown to effectively reduce the symptom of nasal obstruction without any complications. Argon Plasma Coagulation should be an alternative method in treating the patients with hyperplastic inferior turbinate.

[The evaluation of efficaciency of the "Slysze" screening test on the base of the results of hearing examinations in schoolchildren in Silesia in 2002 year]. / Ocena skutecznosci testu przesiewowego "Slysze" na podstawie wyników badan skryningowych sluchu u dzieci na Slasku w 2002 roku.

INTRODUCTION: The measure of efficaciency of screening test is specificality and sensitivity. The validation of the screening test by using Program "Slysze" in Silesia in year 2002 was done. MATERIAL AND METHODS: The Program consisted of two parts: 1. The screening test in schools: a) pure-tone test, b) speech audiometry in noice, and 2. Audiometric verifying of "positive results" of the test. 8885 children were tested in Silesia in 2002. 919 schoolchildren (10.3%) had "positive results". 465 pupils reported to a verifying examination. The hearing loss was confirmed in 191 children. 6 months after the end of Program the control audiometric examinations to validate the Program "Slysze" were done in 100 children, who gained "negative results" in screening test. RESULTS: Program "Slysze" had a high specificality--0.93, sensitivity--0.70, ability to identify--0.92. A positive predictive value was--0.40, and negative predictive value was--0.98.

[The results of surgical treatment of the facial nerve paralysis]. / Wyniki operacji naprawczych porazien nerwu twarzowego.

UNLABELLED: Paralysis of the facial nerve reveales some symptoms which are very unfavourable for esthetic point of view (deformity of the face with incompetence of the palpebal function). It is recognized as the one of the most invalidity for humane life. There are many surgical techniques to reconstructive facial nerve such as: decompression, end to end or side to end anastomosis with hypoglosal, glosopharyngeal, axesorius or mandibular nerves. Reconstruction technique depends upon the extent of injury, the availability of the proximal stump and time since injury and duration of muscle denervation. In the presence of facial paralysis electrodiagnostic tests should be performed before surgery and every 3 mounts after, during rehabilitation, which play also the most important role in recovery. MATERIAL AND METHODS: The authors present the outcome of the surgical treatment of the facial nerve paresis in 31 patients cured in the Silesian Department of Laryngology in Katowice from 1991 to 2002. The reasons of the paresis were otitis media with cholesteatoma and granuloma in 18 cases, head trauma in 2 patients and iatrogenic impairment after ear operations in 11 cases. The decompression of the facial nerve was done in 20 patients, anastomosis end to end in 3, crossover anastomoses between the facial nerve and the hypoglossal nerve was done in 1 case, and transplantation of auricular major nerve in 7 cases. RESULTS: The outcome was good in 20 patients (64.5%), satisfactory in 10 patients (32.3%) and non satisfactory in one case (3.2%). CONCLUSION: In our material the most of cases was caused by otitis media with cholesteatoma. The best outcome was obtained after decompression of the facial nerve. The rehabilitation before and after surgery play the very important role in the recovery.

[A 20-year retrospective histoclinical analysis of parotid gland tumors in the ENT Department AM in Katowice]. / Analiza histokliniczna guzów slinianek przyusznych u chorych operowanych w okresie 20 lat w Klinice Laryngologii SlAM w Katowicach.

INTRODUCTION: Salivary gland neoplasms represent the diverse group of tumours encountered by the head and neck surgeons. MATERIAL AND METHODS: The study is analysis of 531 patients with parotid gland tumours in patients treated in ENT Department during 1986-2006. We analysed surgical treatment and intraoperative tumour stage. The results of histological diagnosis were presented. RESULTS: The frequency of incidence of benign neoplasm was 80%. The most frequent tumour was pleomorphic adenoma--75% and adenolymphoma--16%. Malignant tumours constituted 20% of all gland tumours. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumour. Tumour stages T3-T4 was in 90%.

Schwannomalike mixed tumor of the parotid gland: a case report.

BACKGROUND: Schwannomalike mixed tumor is a rare benign tumor of the parotid glands. CASE: A 75-year-old woman presented with a tumor 3 cm in diameter localized in her left parotid gland. Fine needle aspiration (FNA) of the lesion revealed 2 types of cells: 1 with elongated, wavy, hyperchromatic nuclei and a scant cytoplasmic border and 1 with larger, weakly staining nuclei and more abundant cytoplasm. Morphologic examinations were performed. CONCLUSION: FNA cytology was very useful in the diagnosis of this rare tumor of the parotid gland.