ABSTRACT
Sinonasal non-intestinal-type adenocarcinoma is a rare but important differential diagnosis in patients presenting with recurrent, unexplained epistaxis. Low-grade types have a more favourable prognosis as opposed to the more aggressive high-grade. Symptoms include nasal obstruction and epistaxis that can last up to 5 years. We report a case of a rare low-grade sinonasal non-intestinal-type adenocarcinoma in a 43-year-old male who is frequently exposed to wood and dust particles. Endoscopy revealed right nasal mass occupying the entire nasal cavity as well as inferior turbinate hypertrophy and mass attached to the nasal septum on computed tomography. Biopsy confirmed the diagnosis and was classified as pT1NX with the presence of mitotic figures, which are more commonly present in the high-grade subtype.
ABSTRACT
Lipoatrophy and lipodystrophy can often be used interchangeably in the literature. However, there are some key differences. Inflammation plays a preliminary role in subcutaneous adipose tissue (SAT) loss in lipoatrophy, whereas lipodystrophy does not. There are acquired causes of SAT loss such as injurious stimuli (ie, drug injections), panniculitis, or even microtrauma. Moreover, there are congenital causes such as familial partial lipodystrophy, which follows a more localized pathology, and congenital generalized lipodystrophy, which follow a diffuse spread of SAT loss. These etiologies are further subdivided based on the mutations and clinical presentations. We present a case of a 12-year-old girl with unilateral left lower limb SAT loss since birth, without any signs of inflammation. Therefore, a diagnosis of familial partial lipodystrophy was suspected. However, genetic testing appeared unremarkable. The patient is set for conservative therapy until late adolescence for possible fat grafting.
