ABSTRACT
El carcinoma epidermoide sarcomatoide es una entidad rara en la fosa nasal. Presentamos el caso de un varón de 50 años con una masa polipoide en la cavidad nasal izquierda. En el estudio anatomopatológico, se observa una histología bifásica de nidos escamosos no queratinizantes y un estroma sarcomatoide con positividad para AE1-AE3. El paciente presentó metástasis cervicales ipsilaterales, tratándose con vaciamiento cervical, radioterapia y cisplatino adyuvante. Dos años después se encuentra libre de enfermedad
Spindle cell carcinoma of the nasal cavity is a rare variant of squamous cell carcinoma. We report a case of a 50 year-old male presenting with a polypoid mass in the left nasal cavity. Histologically, the tumor was biphasic, composed of non-keratinizing squamous nests and a sarcomatoid stroma with positivity for CKAE1-AE3. Metastatic ipsilateral lymph nodes were present and the patient underwent radical neck dissection, followed by adjuvant radiotherapy and cisplatin. Two years after diagnosis the patient is free of disease
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Carcinosarcoma/pathology , Nose Neoplasms/pathology , Nasal Cavity/pathology , Neoplasm Metastasis/pathology , Carcinosarcoma/diagnosis , Neoplasm Metastasis/drug therapy , Neoplasm Metastasis/radiotherapy , Disease-Free Survival , ImmunohistochemistryABSTRACT
Spindle cell carcinoma of the nasal cavity is a rare variant of squamous cell carcinoma. We report a case of a 50 year-old male presenting with a polypoid mass in the left nasal cavity. Histologically, the tumor was biphasic, composed of non-keratinizing squamous nests and a sarcomatoid stroma with positivity for CKAE1-AE3. Metastatic ipsilateral lymph nodes were present and the patient underwent radical neck dissection, followed by adjuvant radiotherapy and cisplatin. Two years after diagnosis the patient is free of disease.
Subject(s)
Carcinoma, Squamous Cell/pathology , Nasal Cavity/pathology , Nose Neoplasms/pathology , Sarcoma/pathology , Biomarkers, Tumor/analysis , Carcinoma, Squamous Cell/chemistry , Humans , Male , Middle Aged , Nose Neoplasms/chemistry , Sarcoma/chemistryABSTRACT
Introducción y objetivo: se diseñó una encuesta nacional para analizar el grado de conocimientos teóricos y la actitud de los pediatras ante la laringomalacia por la percepción de que algunos casos graves son infravalorados. Material y método: estudio transversal, descriptivo y analítico, de ámbito nacional, mediante encuesta online. Incluyó pediatras del área hospitalaria y Atención Primaria, diseñándose un cuestionario de 16 preguntas. Las variables recogidas fueron filiación, conocimientos generales, diagnóstico y manejo de la laringomalacia. Resultados: se contestaron 233 encuestas. La actitud mayoritaria ante un caso de laringomalacia era expectante (54,1%), no existiendo diferencias en función de la experiencia de los pediatras, ni por años trabajados ni por número de casos de laringomalacia atendidos. El grado de conocimientos generales de los encuestados fue superior al 89%, disminuyendo al 57% en conocimientos referidos a las laringomalacias graves. El 67% conocía las pruebas complementarias a aplicar en los casos graves y el 73,3% las posibles comorbilidades. El 85,6% coinciden que la ventilación no invasiva puede ser útil en pacientes con laringomalacia grave. Conclusiones: la encuesta muestra que la laringomalacia es una patología conocida, aunque existe disparidad en la actitud inicial a seguir y en las herramientas que utilizan los pediatras para basar su manejo. A pesar de que el grado de conocimiento general conceptual y diagnóstico es adecuado, este disminuye en conceptos más específicos que engloban a los casos de laringomalacia grave. Sería deseable la elaboración de guías clínicas y protocolos para estandarizar el manejo de la laringomalacia (AU)
Background and aims: a national survey was designed to analyze the knowledge and approach of pediatricians to laryngomalacia, due to the perception that some severe cases were overlooked. Materials and methods: this is a national, transversal, descriptive and analytical study, conducted through an on-line survey. We designed a 16 item questionnaire, and targeted both primary care and specialty pediatricians. The variables included professional data filiation, general knowledge, diagnosis and management of laryngomalacia. Results: 233 surveys were answered. The most common approach in a case of suspected laryngomalacia was expectant (54.1%), no differences were found in terms of pediatricians experience, neither by years of time worked, nor by the number of laryngomalacia cases previously assisted. Level of general knowledge shown by participants was higher than 89%, while it decreased to 57% when analyzing items covering severe laryngomalacia. 67% were aware of the additional tests to perform in severe cases, and 73.3% were alert for possible comorbidities. 85.6% agreed that non-invasive ventilation is useful in patients with severe laryngomalacia. Conclusions: the survey shows that laryngomalacia is a well-known condition, although there is not a clear consensus in the initial approach nor in the tools used by pediatricians to base its management. Though the knowledge in general concepts and diagnostics is suitable, it decreases in more specific concepts related to cases of severe laryngomalacia. It would be desirable that clinical guidelines and protocols were developed, to standardize management of laryngomalacia (AU)
