ABSTRACT
By sonography, we found a sharply demarcated tumor with cystic areas in the parotid gland of a 41 year old male, indicating Warthin's tumor. Subtotal parotidectomy was performed. Microscopy showed an encapsulated tumor with myoepithelial cells and, in particular, central pseudocysts. Immunohistochemically, the tumor cells expressed cytokeratin 5/6 and S-100 protein as well as smooth muscle-actin. These features led to the diagnosis of a cystic myoepithelioma. Histopathologically, several different lesions of the salivary glands should be considered in the differential diagnosis of myoepithelioma, especially of this hitherto unique case in the parotid gland. The differential diagnoses are reviewed and discussed. Treatment is by surgical resection. Because of the tendency of myoepitheliomas to recur and to malignant transformation, tumor-free margins are recommended.
Subject(s)
Myoepithelioma/pathology , Myoepithelioma/surgery , Parotid Gland/pathology , Parotid Gland/surgery , Parotid Neoplasms/pathology , Parotid Neoplasms/surgery , Adult , Cysts/classification , Cysts/pathology , Cysts/surgery , Diagnosis, Differential , Humans , Male , Myoepithelioma/classification , Parotid Neoplasms/classification , Treatment OutcomeABSTRACT
Out of total of 164 patients with chronic sinusitis undergoing intranasal microsurgery, 94 patients were submitted to a detailed analysis one year later. The patients were divided into groups of polypoid and hyperplastic sinusitis, depending on the morphological appearances and the histology of the tissue removed. Patients with polyps showed a significantly higher rate of recurrent (47%) than patients with hyperplastic sinusitis (8.6%). Allergy or bronchial asthma did not influence significantly the rate of recurrence in patients with nasal polyposis, whereas patients with a hyperplastic sinusitis showed a higher recurrence rate if they were atopic as well. However, even patients with polypoid sinusitis gained marked long-term relief of nasal obstruction and other symptoms.