Metastatic renal cell carcinoma in the sinonasal region: a case report

Metastatic tumors in the nose and paranasal sinuses are rare. In the present paper, a 68 year old man with metastatic renal cell carcinoma to the left frontoethmoidal region 4 years after initial nephrectomy is presented Pathologic diagnosis of the case was Clear Cell Carcinoma. The patient complained of mild nasal obstruction and intermittent epistaxis, but the significant symptom was bulging in medial canthus from 20 days before. Clinical and endoscopic examinations of the left nasal cavity revealed a vascular mass in the axillary of the middle turbinate and anterior ethmoidal sinuses extending to the left orbital cavity

The patient was treated with partial endoscopic sinus resection and chemoradiotherapy. He had a complete clinical response without any significant complications and recurrence of the tumor after 6 months follow up using interanasal endoscopic examination

Isolation of aspergillus species from nasal cavity and bedroom of healthy volunteers and patients with allergic rhinitis in Mashhad, Iran

The purpose of this study was to investigate the presence, frequency and comparison of Aspergillus spp. in nasal cavity and bedroom of healthy volunteers and patients with allergic rhinitis. In this cross-sectional study, a group of patients with allergic rhinitis [N=50] were selected based on positive skin prick test. Healthy volunteers were chosen to be in the comparison group by matching in age, gender, and no history of respiratory system disease. Samples from nasal cavity and different parts of bedroom were collected and cultured. Cultured Aspergillus spp. was identified by standard mycological techniques. The most common species isolated from all samples of healthy volunteers was A. flavus [88%], followed by A. niger [76%] and A. fumigatus [74%]. A. flavus [56%] was the predominant species isolated from all samples of patients, followed by A. niger [34%] and A. fumigatus [6%]. A. flavus was the most prevalent species of Aspergillus both healthy volunteers and patients. The presence of Aspergillus in homes does not necessarily imply a cause and effect relationship with illness, but we speculate that A. flavus may be a major source of aeroallergens along with A. niger and A. fumigatus; and should alert physicians and healthcare professionals to do more vigorous environmental testing

Urinary melatonin levels and skin malignancy

Melatonin inhibits tumor genesis in a variety of in vivo and in vitro experimental models of neoplasia. In industrialized societies, light at night, by suppressing melatonin production, poses a new risk for the development of a variety of cancers such as breast cancer. This effect on skin has been previously studied only in animals and not in humans. Our goal was to examine the relationship between 24-hour 6-sulphatoxymelatonin levels and skin cancer in a case-control study of 70 patients with skin cancer and 70 healthy individuals. The level of 6-sulfatoxymelatonin was measured in 24-hour urine by the ELISA method. In the case group, 55 [78%] patients had basal cell carcinoma and 15 [22%] had squamous cell carcinoma. The mean level of 24-hour urine 6-sulfatoxymelatonin was significantly higher in the control group [P<0.001]. Also, sleep duration had a significant difference between the two groups [P=0.001]. It seems that a low level of 24-hour urinary 6-sulfatoxymelatonin renders human beings prone to skin cancer. This association, however, requires further investigation

nasal smear for eosinophils, its value, and its relation to nasal mucosal eosinophilia in allergic rhinitis

There is no single test as a gold standard for the diagnosis of allergic rhinitis [AR]. This study was to assess the usefulness and validity of nasal smear as a quick, easy and inexpensive diagnostic method for diagnosis of allergic rhinitis. This study was conducted in a university hospital setting. Nasal smears were taken from 39 patients with a clinical history of nasal allergy and a positive skin prick test to at least one aeroallergen as well as 26 controls without any history and negative test. Biopsy specimens from the inferior turbinate as well as nasal smears of 19 cases including 9 patients and 10 controls with the same criteria were taken. Nasal smears and biopsy slides were stained with Giemsa and Hematoxilin-Eosin and were examined blindly by two separate pathologists. Fifty one percents of the patients and 11.5% of the controls showed eosinophilia in their nasal smear [>/=10% eosinophils, P=0.001]. The sensitivity of nasal eosinophil count as a diagnostic test for AR was 51.3% with a specificity of 88.5%, a positive predictive value of 87% and a negative predictive value of 54%. Eosinophilia in nasal biopsies was found in 44% and 30% of allergic patients and controls respectively. There was no significant correlation between symptoms or positive skin tests with either smear eosinophilia or tissue eosinophilia. Evaluation of eosinophils in nasal smear is an insensitive but fairly specific test for the diagnosis of allergic rhinitis. It seems that the nasal secretions and nasal tissue represent two distinct cellular compartments

Tip graft and columellar strut using dorsal osseocartilaginous hump

Although, different grafts are used for nasal tip plasty in cases with under projected or ill defined tip, the selection of a graft material, which provides sufficient amount of tissue with least donor site morbidity and low recipient site complication is challenging. The objectives of the present study were to examine the usefulness of cartilaginous dorsum as a proper material for tip graft, and to introduce the cartilaginous dorsum as an acceptable material for columellar strut. Fifty six [18 males and 38 females] patients were operated for augmentation tip plasty and hump reduction from 2004 to 2008. The tailored cartilaginous or ostecartilaginous dorsum was used as a tip graft or columellar strut in 35 and 21 cases, respectively. The cartilaginous framework was exposed using open or close rhinoplasty approach in 41 and 15 cases, respectively. The patients were followed for 12- 36 months. Cosmetic outcomes and patients' satisfaction were obtained using qualitative measures. The percentage of patients with very improved, improved, unchanged or unacceptable aesthetic outcome were 39.29%, 50%, 3.57% and 7.14%, respectively. Moreover, the percentages of very satisfied, satisfied, indifferent and unsatisfied patients were 66%, 18%, 9%, and 7%, respectively. The procedure provides a well-defined nasal tip with no evidence of bifidity, angularity, or cartilage graft visibility and displacement. The use of dorsal osteocartilaginous graft offers outstanding advantages including ease of harvest, mould, fix, and low resorption