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1.
Artigo em Chinês | MEDLINE | ID: mdl-31954384

RESUMO

Objective: To analyse the outcomes and the prognostic factors of patients with sinonasal malignancies following endoscopic endonasal approach, and to compare the pre- and post-operative quality of life. Methods: A retrospective single-center review of 79 patients who underwent endoscopic endonasal approach for sinonasal malignancies in Beijing Tongren Hospital from October 2004 to March 2017 was performed, including 51 males and 28 females, with a median age of 48 years. Data of demography, imaging (including nasal CT and MRI before operation), histopathology and treatment strategy were collected. Recurrence and distant metastasis were diagnosed according to endoscopic examination, MRI and general check-up after surgery. Pre- and post-operative quality of life scores were obtained by sinonasal outcome test-22, visual analog scale and anterior skull base surgery questionnaire. SPSS 22 software was used for statistical analysis. Results: The study consisted of 13 pathological types with sinonasal T1-T4 stage tumors, including cervical lymph nodes and/or distant metastasis. All patients underwent endoscopic endonasal approach surgery. After 43 months of median follow-up time, the overall, disease-free, and recurrence-free survival rates at 1, 3, 5 and 10 years was 97.4%, 92.5%, 92.5% and 83.7%; 83.2%, 68.3%, 56.8% and 33.6%; 84.5%, 66.6%, 58.0% and 34.4%, respectively. Postoperative recurrence was an independent risk factor affecting the overall survival rate (HR=8.852, P=0.044), and preoperative recurrence (secondary surgery) was an independent risk factor affecting the disease-free and recurrence-free survival rate (HR value was 2.237 and 2.095 respectively, P value was 0.029 and 0.047 respectively). After surgery, the olfaction and nasal scab got worse, while the nasal obstruction and breathing were improved. Conclusions: Endoscopic endonasal approach for sinonasal malignancies can achieve satisfactory outcomes, and has obvious advantages in improving the quality of life. Postoperative recurrence and preoperative recurrence are the prognostic factors.


Assuntos
Endoscopia/métodos , Neoplasias dos Seios Paranasais/cirurgia , Qualidade de Vida , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
4.
World Neurosurg ; 133: 260-265, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31605847

RESUMO

BACKGROUND: Coexistence of sinonasal and skull base tumors is uncommon but possible, and the endonasal route seems to be the best option to manage both lesions simultaneously. We report the first case in the English literature of concomitant sphenoid sinus inverted papilloma and pituitary macroadenoma treated through an endoscopic endonasal approach. CASE DESCRIPTION: A 68-year-old man presented with a history of progressive visual loss and nasal obstruction. Clinical examination disclosed bitemporal hemianopsia. Computed tomography scan and magnetic resonance imaging obtained on admission showed a large sellar/suprasellar enhancing lesion with a marked mass effect on the optic chiasm. Imaging also showed a second mass extending from the sphenoid sinus to the left nasal cavity with obstruction of the maxillary sinus ostium and development of maxillary sinus mucocele. Both tumors were entirely resected by an endoscopic endonasal approach. Additionally, middle meatal antrostomy and marsupialization with drainage of the maxillary mucocele was performed. Biopsy confirmed the coexistence of a pituitary macroadenoma and sphenoid sinus inverted papilloma. CONCLUSIONS: This case and the literature suggest that patients with concomitant nasal and skull base pathologies can be simultaneously managed. The otolaryngologist plays an essential role in removing the sinonasal lesion to ensure a safe surgical corridor before entering the intracranial cavity and for planning for the skull base reconstruction.


Assuntos
Adenoma/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Neoplasias Hipofisárias/cirurgia , Seio Esfenoidal/cirurgia , Adenoma/diagnóstico por imagem , Adenoma/patologia , Idoso , Humanos , Imagem por Ressonância Magnética , Masculino , Cirurgia Endoscópica por Orifício Natural/métodos , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Primárias Múltiplas/patologia , Neuroendoscopia/métodos , Papiloma Invertido/diagnóstico por imagem , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/patologia , Seio Esfenoidal/diagnóstico por imagem , Seio Esfenoidal/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Ophthalmic Plast Reconstr Surg ; 35(6): e136-e138, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31567913

RESUMO

The development of orbit-eroding mucocele associated with inverted papilloma has been rarely reported., Here, the authors present a case and surgical management of a patient with orbit-eroding mucocele associated with inverted papilloma who declined craniotomy. A combined approach utilizing frontal endoscopic sinus surgery and external sub-brow anterior orbitotomy was used to explore, drain, and excise the mucocele and inverted papilloma. Gelatin sponges soaked in gentamicin were used to cover the exposed dura and to protect the orbital content from the frontal sinus cavity.A fronto-ethmoidal sinus inverted papilloma associated with recurrent orbit-eroding mucocele was excised by combined transnasal endoscopic and external sub-brow anterior orbitotomy approach using stereotactic navigation.


Assuntos
Seio Etmoidal/patologia , Mucocele/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Doenças Orbitárias/cirurgia , Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Idoso , Humanos , Masculino , Papiloma Invertido/complicações , Neoplasias dos Seios Paranasais/complicações , Resultado do Tratamento
6.
Vestn Otorinolaringol ; 84(4): 6-12, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31579049

RESUMO

PURPOSE: To describe the principles of medical navigation systems in head and neck surgery, the possibility of their application and the existing limitations. MATERIAL AND METHODS: The article presents the generalized experience of image-guidance equipment using in the ENT Department of First Pavlov State Medical University. 298 operations, mostly FESS, were performed from 2013 to 2018 under the control of navigation system. The majority of cases consisted of surgical treatment of chronic sinusitis, tumors of the nasal cavity and paranasal sinuses; also, navigation control was useful in the case of altered intranasal anatomy after previous surgical treatment or due to chronic polyposis. A case report of frontal sinus inverted papilloma surgical treatment, controlled by an electromagnetic navigation system, is presented. RESULTS: The use of navigation systems in head and neck surgery can improve surgery accuracy and safety, as well as providing a unique opportunity to learn FESS in real time.


Assuntos
Neoplasias dos Seios Paranasais , Sinusite , Cirurgia Assistida por Computador , Endoscopia , Humanos , Cavidade Nasal , Neoplasias dos Seios Paranasais/cirurgia , Seios Paranasais , Sinusite/cirurgia
7.
Orv Hetil ; 160(40): 1584-1590, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31565974

RESUMO

Introduction: Malignant tumours of the sinonasal region - including those with invasion of the skull base - necessitate surgical resection. The majority of the cases give an opportunity to perform the procedure via minimally invasive, endoscopic approach, without external, craniofacial surgery. Aim: To assess our clinical experience in treating anterior skull base malignancies, performing minimally invasive endoscopic transcribriform resection. Method: Between February 2015 and July 2017, four male and one female patient underwent minimally invasive, endoscopic skull base procedure. The mean age was 64.6 years (59-70, median: 66). Every surgery was performed via transnasal, endoscopic transcribriform approach. In two cases Kadish C esthesioneuroblastomas, while in one case a T3N0 sinonasal non-differentiated carcinoma, a T1N0 intestinal type adenocarcinoma and a T4N0 squamous cell carcinoma was the indication of surgery, respectively. Results: The mean follow-up time was 22.8 months, between 14 and 46 months. Intraoperative complications did not occur during the procedures. Regarding the postoperative period, liquorrhoea and pneumocephalus occurred in one case. Complications were solved with lumbar drainage. During follow-up, neither residual nor recurrent tumour was observed in our patients. Conclusion: Endoscopic transcribriform resection of the skull base malignancies is a safe and viable alternative to the traditional open approach. Orv Hetil. 2019; 160(40): 1584-1590.


Assuntos
Endoscopia , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Neuroendoscopia/métodos , Procedimentos Neurocirúrgicos/métodos , Neoplasias dos Seios Paranasais/cirurgia , Neoplasias da Base do Crânio/cirurgia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Recidiva Local de Neoplasia , Neuroendoscopia/efeitos adversos , Neoplasias dos Seios Paranasais/patologia , Base do Crânio/cirurgia , Neoplasias da Base do Crânio/patologia , Resultado do Tratamento
8.
Ophthalmic Plast Reconstr Surg ; 35(4): e102-e104, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31283698

RESUMO

The authors report 2 consecutive adult male patients, aged 61 and 38 years, who presented with painless unilateral proptosis. Their past medical histories were negative for asthma, allergies, and Graves disease. On examination, the nose bridge of the eldest patient was clearly enlarged. Computed tomography scans of the orbits and paranasal sinuses showed in both patients the same radiologic pattern of hyperdense ethmoidal opacifications and expansion of the inferomedial orbital floor. Histopathological analysis of the ethmoidal cells mucosa obtained during inferomedial decompression revealed benign sinonasal polyposis. These cases demonstrate that asymptomatic sinonasal polyposis can be a rare cause of proptosis.


Assuntos
Exoftalmia/etiologia , Pólipos Nasais/complicações , Neoplasias dos Seios Paranasais/complicações , Seios Paranasais/diagnóstico por imagem , Adulto , Descompressão Cirúrgica/métodos , Diagnóstico Diferencial , Endoscopia , Exoftalmia/diagnóstico , Exoftalmia/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/diagnóstico , Pólipos Nasais/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/cirurgia , Seios Paranasais/cirurgia , Pólipos/complicações , Pólipos/diagnóstico , Pólipos/cirurgia , Doenças Raras , Síndrome , Tomografia Computadorizada por Raios X
9.
J Craniofac Surg ; 30(5): e432-e433, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299804

RESUMO

Angiofibroma is a rare tumor that accounts for about 0.05% of all head and neck tumors; it mainly occurs in the region of the nasopharynx. To date, no study originating in the frontal sinus has been reported. The authors report a report of an 18-year-old male complaining of severe pain in the right periocular area, forehead, and temporal area for 1 week. Endoscopic sinus surgery in combination with trephination was used to remove the tumor and the tumor was diagnosed as angiofibroma from histopathologic examination. It is hard to consider a tumor as being angiofibroma when it is not located in the nasopharynx. In particular, although extranasopharyngeal angiofibroma can occur in all head and neck regions, a tumor which has developed in the frontal sinus is more difficult to diagnose as angiofibroma because no patients have been reported until now. With this study, surgeons now need to be aware of the possibility of occurrence of angiofibroma in the frontal sinus.


Assuntos
Angiofibroma/diagnóstico por imagem , Seio Frontal/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Adolescente , Angiofibroma/cirurgia , Testa/cirurgia , Seio Frontal/cirurgia , Humanos , Masculino , Nasofaringe , Neuroendoscopia , Neoplasias dos Seios Paranasais/cirurgia , Trepanação
10.
J Craniofac Surg ; 30(7): e622-e623, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31157640

RESUMO

Osteomas are benign, slow-growing tumors originating from bone tissue. Osteomas of the paranasal region, which are usually asymptomatic, are detected incidentally on tomographies taken for other medical needs. Paranasal sinus osteomas frequently localized in the frontal and ethmoid sinuses are among the infrequent reasons for headaches. In this case report, the authors submit the first case of an osteoma that was localized inside the middle concha bullosa and causing headache. It was successfully excised via an endoscopic endonasal approach without any complications.


Assuntos
Seio Etmoidal/cirurgia , Cefaleia/etiologia , Neoplasias Nasais/cirurgia , Osteoma/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Adolescente , Humanos , Masculino , Neoplasias Nasais/complicações , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/patologia , Osteoma/complicações , Osteoma/diagnóstico por imagem , Osteoma/patologia , Neoplasias dos Seios Paranasais/complicações , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Tomografia Computadorizada por Raios X
11.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 33(5): 447-450;454, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31163555

RESUMO

Objective: To investigate the clinicopathological features and the clinical characteristics of inflammatory myofibroblastic tumor(IMT) of paranasal sinus. Method: Five cases of IMT of paranasal sinus treated from 2011 to 2018 were analyzed retrospectively. Of the 5 patients, CT and MRI were performed before operation. All tumors originated from paranasal sinus, and orbital, pterygopalatine fossa and palate was involved with variable degrees. All patients had been given operation and recovered well. Two cases received additional glucocorticoid therapy(prednisone) postoperatively. Result: After a follow-up of 3-80 months, one case recurred 2 years postoperatively and received surgery again. No recurrence was found after operation in the other four patients. The finial diagnosis depended on pathological findings. Postoperative pathological examination showed that the tumor cells were mainly composed of spindle fibroblasts and chronic inflammatory cells. Immunohistochemical staining showed positive expression of SMA protein. Conclusion: IMT of paranasal sinus is a rare clinical entity without specific clinical manifestations and the extent of the lesion can be assessed by imaging examinations. Pathological examination is required for final diagnosis. Radical resection should be taken for limited lesions. Besides surgery, corticosteroid administration and irradiation therapy is recommended in some circumstances. The overall prognosis is good.


Assuntos
Neoplasias dos Seios Paranasais/cirurgia , Humanos , Recidiva Local de Neoplasia , Neoplasias dos Seios Paranasais/patologia , Seios Paranasais/patologia , Seios Paranasais/cirurgia , Prednisona/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento
12.
Ann Otol Rhinol Laryngol ; 128(11): 1078-1080, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31204488

RESUMO

OBJECTIVES: Inflammatory myofibroblastic tumor (IMT) is a rare benign lesion, especially in the pediatric age. There are several cases described in pulmonary, digestive and renal localizations, but involvement in head and neck area is infrequent. METHODS: Case report and review of the literature. RESULTS: A 1 year and 11 months old child, during 2 months had clinical signs of nasal respiratory insufficiency and epistaxis subsequently developing a purulent rhinorrhea and a sleep apnea. His pediatrician previously requested a sinus and cavum X-ray with the finding of an image compatible with an intranasal mass. Endoscopic resection was performed of the mass with further immunohistochemical analysis showing the result of a lesion compatible with IMT. CONCLUSIONS: Even though there are very few cases in scientific literature of a tumor with these characteristics in infants, IMT must be present as a differential diagnosis of intranasal masses. The role of the pathologist is essential to reach the definitive diagnosis and the performance of an early surgical treatment decreases aesthetic consequences in this pathology.


Assuntos
Endoscopia/métodos , Epistaxe/etiologia , Cavidade Nasal/patologia , Neoplasias de Tecido Muscular/diagnóstico , Neoplasias dos Seios Paranasais/diagnóstico , Seios Paranasais/diagnóstico por imagem , Diagnóstico Diferencial , Epistaxe/diagnóstico , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Neoplasias de Tecido Muscular/complicações , Neoplasias de Tecido Muscular/cirurgia , Neoplasias dos Seios Paranasais/complicações , Neoplasias dos Seios Paranasais/cirurgia , Tomografia Computadorizada por Raios X
13.
J Cancer Res Ther ; 15(3): 733-736, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31169254

RESUMO

Angiectatic sinonasal polyps are uncommon. However, riveting nature of this polyp lies in its clinical presentation mimicking a neoplasm. It is radiologically very challenging to pick up this lesion in spite of its characteristic findings on imaging. Histopathology is paramount for asserting diagnosis. We report a rare case of a patient who presented to our outpatient department with chief complaints of nasal block, nasal discharge, and epiphora for 6 months. On examination, a mass was found filling the left nasal cavity. Computed tomography scan and diagnostic nasal endoscopy were suggestive of fungal sinusitis or sinonasal malignancy as a differential diagnosis. Biopsy was reported as benign sinonasal polyp. The patient underwent endoscopic resection of the mass, which on histopathology revealed the diagnosis of an angiectatic sinonasal polyp.


Assuntos
Pólipos Nasais/diagnóstico , Neoplasias dos Seios Paranasais/diagnóstico , Biópsia , Diagnóstico Diferencial , Endoscopia , Feminino , Humanos , Pólipos Nasais/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Avaliação de Sintomas , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
15.
World Neurosurg ; 128: 506-513, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31132485

RESUMO

OBJECTIVE: To describe a novel bilaterally pedicled pericranial flap for anterior cranial base reconstruction after removal of complex frontobasal cancers extending to the frontal region, thus precluding the use of standard reconstructive techniques. METHODS: In selected oncologic cranial base surgeries, the use of the standard galea frontalis pericranial flap for reconstructive purposes may be precluded by tumor infiltration. In such cases, dura mater reconstruction and exclusion of frontal sinuses from the intracranial space can be performed using a large superficial temporal artery bilaterally pedicled pericranial flap obtained from both temporoparietal regions. Surgical technique, indication, contraindication, complications, and degree of resection are recorded to evaluate the efficacy of this surgical method. RESULTS: A 48-year-old man affected by a recurrence of frontobasal squamous cell carcinoma was surgically treated by combined transcranial and endoscopic endonasal resection. A large pericranial flap pedicled bilaterally on the parietal branches of the superficial temporal artery was obtained, transposed anteriorly, carefully watertight sutured to the dural defect, and used to exclude cranialized frontal sinuses as well. The reconstruction was successful, and the patient was discharged home on the tenth postoperative day without any complications and/or development of cerebrospinal fluid leak. Contrast-enhanced magnetic resonance imaging 3 months after surgery was clear from disease with consolidated surgical outcomes. CONCLUSIONS: This novel pericranial flap seems to be easily obtained and effective for anterior cranial base reconstruction when the use of a traditional galea frontalis flap is precluded for oncologic reasons and there are concerns for the possible development of contaminations and cerebrospinal fluid leaks.


Assuntos
Seio Frontal/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Base do Crânio/cirurgia , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Retalhos Cirúrgicos , Fossa Craniana Anterior , Osso Frontal , Seio Frontal/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Masculino , Maxila/cirurgia , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia/diagnóstico por imagem , Procedimentos Neurocirúrgicos/métodos , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Base do Crânio/diagnóstico por imagem , Base do Crânio/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem
16.
World Neurosurg ; 128: e409-e416, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31042605

RESUMO

BACKGROUND: Endoscopic endonasal anterior skull base malignant sinonasal tumor resection and reconstruction remains a challenge. We describe our septal flip flap (SFF) reconstruction, a new surgical technique for repairing anterior skull base defects and report our outcomes. METHODS: We retrospectively reviewed the clinical data of 24 patients who underwent skull base reconstruction using a SFF following endoscopic resection with transnasal craniectomy. We raise the SFF from the contralateral nasal septum based on the septal branches of the anterior and posterior ethmoidal arteries; the SFF is then rotated laterally for anterior skull base reconstruction after transnasal resection with craniectomy. RESULTS: The SFF was used for multiple tumor types including, most commonly, intestinal-type adenocarcinoma, followed by olfactory neuroblastoma, squamous cell carcinoma, sinonasal undifferentiated carcinoma, and other types. All of the cases had either preoperative or postoperative radiation therapy. All flaps remained viable postoperatively. Postoperatively, nasal crusting was significantly reduced with faster healing of the surgical cavity. CONCLUSIONS: The SFF adds to the clinical armamentarium the opportunity to provide vascularized mucosal coverage extending from the frontal recess back to the planum sphenoidalis. The use of SFF requires careful consideration when dealing with paranasal sinus cancers so as not to infringe oncologic principles.


Assuntos
Septo Nasal/cirurgia , Neoplasias Nasais/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Base do Crânio/cirurgia , Retalhos Cirúrgicos , Adenocarcinoma/cirurgia , Adolescente , Adulto , Idoso , Carcinoma/cirurgia , Craniotomia/métodos , Estesioneuroblastoma Olfatório/cirurgia , Feminino , Humanos , Masculino , Neoplasias do Seio Maxilar/cirurgia , Pessoa de Meia-Idade , Cavidade Nasal/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Neuroendoscopia/métodos , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Adulto Jovem
17.
Acta Cytol ; 63(5): 431-437, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31132763

RESUMO

SMARCB1 (INI-1)-deficient sinonasal carcinoma is a rare entity within the subgroup of poorly differentiated sinonasal tract carcinomas. As there are only two papers describing the cytologic features of this entity, herein we describe the unique cytomorphologic features of a pulmonary metastasis of this tumor and include the differential diagnosis based on tumor location. The patient was a 53-year-old male who initially presented with sinus congestion and vision changes including left-eye proptosis and diplopia. The initial biopsy of the ethmoid-centered sinonasal mass was non-keratinizing squamous cell carcinoma based on strong immunoreactivity with p40 and absence of immunoreactivity for chromogranin, synaptophysin, p16, and EBER. However, the final diagnosis of the surgical resection was amended to SMARCB1 (INI-1)-deficient sinonasal carcinoma after additional immunohistochemical stains were performed. Post-primary resection, follow-up computed tomography imaging revealed significant interval progression of a solitary, initially indeterminate 1-cm lung nodule in the left upper lobe. Endobronchial ultrasound-guided fine-needle aspiration with concomitant core-needle biopsy was performed. Rapid on site evaluation of cytologic smears revealed a hypercellular specimen consisting of sheets of epithelioid cells with very scant to absent cytoplasm, ill-defined cell borders, enlarged fragile nuclei, and areas of nuclear molding. Mitotic figures were present. Other areas showed tumor cells with spindled to elongated nuclei and scant to ill-defined wispy cytoplasm. Both cytology cell block and core-needle biopsy histopathologic material showed the tumor cells to be negative for INI-1 nuclear staining as well as CK5/6, CAM5.2, p40, p63, CK7, AE1/3, and TTF-1. SMARCB1 (INI-1)-deficient sinonasal carcinoma can have a spectrum of morphologies and may mimic "small-round-blue-cell" and spindle-cell tumors on cytology preparations. Given the pulmonary location of the aspirate, familiarity with the cytomorphologic spectrum of SMARCB1 (INI-1)-deficient sinonasal carcinoma, inclusion of this entity within the differential diagnosis, and performance of immunohistochemistry will aid in arriving at the correct diagnosis.


Assuntos
Biomarcadores Tumorais/deficiência , Carcinoma/química , Carcinoma/secundário , Diferenciação Celular , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Neoplasias dos Seios Paranasais/química , Neoplasias dos Seios Paranasais/patologia , Proteína SMARCB1/deficiência , Carcinoma/cirurgia , Diagnóstico Diferencial , Predisposição Genética para Doença , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/cirurgia , Fenótipo , Valor Preditivo dos Testes , Reprodutibilidade dos Testes
18.
BMJ Case Rep ; 12(5)2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31142486

RESUMO

Esthesioneuroblastoma is an uncommon tumour, and isolated primary involvement of the maxillary sinus is exceedingly rare. Esthesioneuroblastoma has infrequently been reported as a source of paraneoplastic ectopic hormone production. We report a case of isolated primary maxillary esthesioneuroblastoma, presenting as idiopathic syndrome of inappropriate antidiuretic hormone (SIADH). A 17-year-old girl presented with symptoms consistent with SIADH and no sino-nasal symptoms. MRI to exclude pituitary tumour revealed an isolated lesion of the right maxillary sinus. Biopsy demonstrated esthesioneuroblastoma. The lesion was removed endoscopically as a single en bloc specimen. Following resection, the sodium level returned to normal. This is only the third report in the literature of a primary maxillary esthesioneuroblastoma presenting as SIADH.


Assuntos
Estesioneuroblastoma Olfatório/complicações , Síndrome de Secreção Inadequada de HAD/etiologia , Síndrome de Secreção Inadequada de HAD/cirurgia , Seio Maxilar , Cavidade Nasal , Neoplasias Nasais/complicações , Adolescente , Estesioneuroblastoma Olfatório/radioterapia , Estesioneuroblastoma Olfatório/cirurgia , Feminino , Humanos , Síndrome de Secreção Inadequada de HAD/radioterapia , Imagem por Ressonância Magnética , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia , Neoplasias dos Seios Paranasais/complicações , Neoplasias dos Seios Paranasais/radioterapia , Neoplasias dos Seios Paranasais/cirurgia , Radioterapia Adjuvante
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