RESUMO
PURPOSE: To report a series of 15 new cases of nasopharyngeal angiofibroma treated with presurgical embolization along with a review of the literature. MATERIALS AND METHOD: Retrospective review of 15 cases of nasopharyngeal angiofibroma treated with presurgical embolization. The clinical, CT and MR features as well as postsurgical follow-up are reviewed. RESULTS: Presurgical embolization reduced surgical difficulties, especially hemorrhage, allowing complete tumor resection in most cases. Two cases of recurrent disease and 1 case of residual tumor were noted and treated by repeat embolization. CONCLUSION: Presurgical embolization reduces intraoperative hemorrhage and allows complete resection of these highly vascularized tumors.
Assuntos
Angiofibroma/terapia , Embolização Terapêutica/métodos , Neoplasias Nasofaríngeas/terapia , Adolescente , Adulto , Angiofibroma/cirurgia , Angiografia , Perda Sanguínea Cirúrgica/prevenção & controle , Criança , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Artéria Maxilar , Neoplasias Nasofaríngeas/cirurgia , Recidiva Local de Neoplasia/terapia , Neoplasia Residual , Polivinil/uso terapêutico , Cuidados Pré-Operatórios , Retratamento , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
Mucormycosis is a rare and acute fungal infection which is frequently lethal, usually observed in non-controlled diabetic patients. The infection usually begins in the nose but it can invade the lung, the digestive tract, and the skin. Rhinocerebral mucormycosis accounts for 40 to 49% of mucormycosis cases. We report the case of a 53-year-old diabetic man, with chronic renal failure, presenting with rhinocerebral mucormycosis. Our patient was treated by an association of amphotericin B and surgical debridement. This observation provides on opportunity to recall clinical, histopathological, and therapeutic aspects of rhinocerebral mucormycosis.
Assuntos
Encefalopatias/microbiologia , Complicações do Diabetes/microbiologia , Mucormicose/diagnóstico , Encefalopatias/patologia , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/microbiologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Mucormicose/patologia , Mucormicose/cirurgiaAssuntos
Colesteatoma , Meato Acústico Externo , Otopatias , Adulto , Idoso , Colesteatoma/diagnóstico , Colesteatoma/cirurgia , Otopatias/diagnóstico , Otopatias/cirurgia , Feminino , Humanos , Masculino , Adulto JovemRESUMO
OBJECTIVES: To define the epidemiological and clinical features and complementary investigation findings of extranodal NK/T-cell lymphoma, nasal type and to discuss the diagnostic difficulties and the various treatment options. PATIENTS AND METHODS: This retrospective study was based on 15 patients with extranodal NK/T-cell lymphoma, nasal type, managed between 1990 and 2009. RESULTS: This series comprised 13 men and two women (sex ratio=6.5) with a mean age of 52 years (range: 35-81 years). The mean time to first consultation was 6 months. The most common symptoms were nasal obstruction (87%) and purulent nasal discharge (73%), followed by epistaxis (60%). Physical examination demonstrated the presence of a tumour of the nasal cavity in 11 patients. The diagnosis was confirmed by histological examination of a biopsy completed by immunohistochemistry. CT scan of the facial bones was performed in all patients of this series. The site of extranodal NK/T-cell lymphoma was essentially nasal (12 cases). Orbital extension was observed in four cases, associated with intracranial extension in two cases and osteolysis was observed in 11 patients. Lymphomas were classified as stage IE in 74% of cases and stage IIE in 26% of cases. Only one patient was lost to follow-up during treatment. Three patients died before any treatment. Treatment therefore concerned 12 patients. Stage IE lymphomas were treated by radiotherapy and/or chemotherapy. All stage IIE lymphomas were treated by chemotherapy alone. Stage IE patients had a better prognosis. CONCLUSION: Extranodal NK/T-cell lymphoma, nasal type, is an aggressive form of non-Hodgkin's lymphoma comprising specific clinicopathological characteristics. The addition of chemotherapy for advanced stages does not appear to improve survival compared radiotherapy alone, which remains the treatment of choice especially for localized stages.
Assuntos
Linfoma Extranodal de Células T-NK/diagnóstico , Linfoma Extranodal de Células T-NK/terapia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Quimiorradioterapia , Estudos Transversais , Diagnóstico Diferencial , Tratamento Farmacológico , Feminino , Humanos , Linfoma Extranodal de Células T-NK/mortalidade , Linfoma Extranodal de Células T-NK/patologia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Neoplasias Nasais/mortalidade , Neoplasias Nasais/patologia , Órbita/patologia , Seios Paranasais/patologia , Radioterapia , Estudos Retrospectivos , Taxa de Sobrevida , Tomografia Computadorizada por Raios XRESUMO
Most of the sinonasal tumours are of epithelial origin. Smooth muscle tumours are extremely rare, they account for less than 2.5% of the mesenchymal neoplasms of the sinonasal tract and the nasopharynx. Fewer than 30 cases of primary leiomyogenic tumours have been reported in the sinonasal tract with almost an equal frequency of benign and malignant types. We report a case of a rare leiomyoma of the nasal cavity. The pathological and the clinical characteristics of this tumour are discussed.