ABSTRACT
OBJECTIVES: Mucosal melanoma of the nasal cavity and paranasal sinuses is a rare and highly aggressive tumor. We report our experience over 20 years in management of this tumor. PATIENTS AND METHODS: A retrospective study included 14 patients with primary sinonasal mucosal melanoma. RESULTS: The series comprised 8 male and 6 female patients, with a median age at diagnosis of 67 years. Staging on the American Joint Committee on Cancer classification of sinus cancer was 14% T2, 22% T3, 75% T4a and 7% T4b. All patients underwent primary surgical treatment; 71% received adjuvant external radiotherapy. Median recurrence-free interval was 28.7 months. Two- and 5-year overall survival was 43% and 32%, respectively. Median follow-up was 43 months. CONCLUSIONS: Mucosal melanomas of the nasal cavity and paranasal sinuses are very specific entities. Limited pathophysiological knowledge still precludes effective medium- and long-term management. Future treatment will probably be based on global adjuvant or neoadjuvant-targeted chemotherapy.
Subject(s)
Melanoma/pathology , Nasal Cavity/pathology , Nasal Mucosa/pathology , Nose Neoplasms/pathology , Paranasal Sinus Neoplasms/pathology , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Melanoma/mortality , Melanoma/therapy , Middle Aged , Nasal Cavity/surgery , Nasal Mucosa/surgery , Neoplasm Recurrence, Local , Nose Neoplasms/mortality , Nose Neoplasms/therapy , Paranasal Sinus Neoplasms/mortality , Paranasal Sinus Neoplasms/therapy , Radiotherapy, Adjuvant , Retrospective StudiesABSTRACT
OBJECTIVES: To illustrate, via a case report, how a differential diagnosis of amyloidosis is to be suspected in case of a nasopharyngeal mass. CASE REPORT: A 59-year-old woman presented with bilateral nasal obstruction with associated episodic tubal dysfunction. Physical examination found a mass occupying the entire nasopharynx, initially suggestive of tumor. DISCUSSION: Amyloidosis was diagnosed on histopathologic study of the biopsy and surgical specimens. Exploration for systemic disease proved negative. The localized amyloidosis was managed conservatively. At 9 months' follow-up, there was no recurrence. CONCLUSION: Localized amyloidosis, however rare, should be considered as differential diagnosis in any case of nasal obstruction with tubal dysfunction, even if bilateral. ENT physicians need to recognize and understand this pathology for adapted diagnostic and treatment planning.
Subject(s)
Amyloidosis/diagnosis , Nasopharyngeal Diseases/diagnosis , Amyloidosis/pathology , Amyloidosis/surgery , Biopsy , Contrast Media/administration & dosage , Diagnosis, Differential , Female , Gadolinium , Humans , Magnetic Resonance Imaging , Middle Aged , Nasopharyngeal Diseases/pathology , Nasopharyngeal Diseases/surgery , Nasopharyngeal Neoplasms/diagnosis , Nasopharyngeal Neoplasms/pathology , Nasopharyngeal Neoplasms/surgery , Nasopharynx/pathology , Nasopharynx/surgery , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To describe diagnostic and therapeutic management of a rare parotid lesion: sclerosing polycystic adenosis. PATIENT AND METHOD: We report a case of persistent right intraparotid tumefaction. RESULTS: A 68-year-old man was referred with a right parotid nodule of 2 years' evolution. Cytology diagnosed pleomorphic adenoma, verified on MRI. Conservative subtotal parotidectomy diagnosed sclerosing polycystic adenosis. Over 1 year's regular follow-up, there were no signs of local recurrence. CONCLUSION: Sclerosing polycystic adenosis of the parotid gland is a rare and recently described entity presenting several analogies to the much more frequent cystic mastitis. Although benign and well-delimited, it requires complete exeresis of the parotid, due to a non-negligible risk of recurrence.
