Chondroma of the Nasal Septum.

Chondromas are benign cartilaginous tumours that rarely occur in the head and neck region. Only a limited number of cases have been reported involving the nasal septum. Here we report a case of a 55-year-old male that presented with a suspicious lesion involving his nasal septum and columella. The lesion was removed under general anesthestic using a combination of both columellar and hemitransfixion incisions. The lesion consisted of firm tan-white tissue measuring 2.5 cm. Histopathologic examination revealed a low-grade chondroid neoplasm with lobulated hyaline cartilage. No signs of ischemic change, significant pleomorphism, mitoses, or necrosis were present. This was consistent with the features of a chondroma rather than a low-grade chondrosarcoma. A chondroma should be considered in the differential diagnosis of nasal septum lesions. Surgical excision of the tumour is the preferred treatment option.

Universal tumor screening for Lynch syndrome: Perceptions of Canadian pathologists and genetic counselors of barriers and facilitators.

BACKGROUND: People at risk of developing hereditary cancers associated with Lynch Syndrome (LS) can be identified through universal screening of colorectal tumors. However, tumor screening practices are variable across Canada and few studies explore the perspectives of genetic counselors and pathologists about tumor screening. This study was conducted to better understand the barriers and facilitators of implementing universal tumor screening in health centers across Canada. METHODS: An online survey about tumor screening programs was administered to genetic counselors and pathologists across Canada through communication channels of professional organizations. It was hosted on SurveyMonkey and accessible from October 2016 to March 2017. RESULTS: Barriers to tumor screening included a lack of sustainable resources, including funding and genetic counselors. Respondents strongly identified the need for a coordinated, interdisciplinary approach to program planning with the "right people at the table." Respondents currently with a screening program provided advice such as carefully designing the program structure, developing patient and family follow-up protocols, and ensuring adequate resources (funding, staff, training for providers) were available prior to program initiation. CONCLUSION: There is no national approach to universal tumor screening in Canada. However, future efforts can be informed by the experiences of those centers that have already created a universal tumor screening program for LS. These data suggest the need for an interdisciplinary approach, initial and sustained funding, and careful advanced planning of program structures and policies.

Universal tumor screening for Lynch syndrome: perspectives of Canadian pathologists and genetic counselors.

Universal screening of all newly diagnosed colorectal cancer tumors can identify individuals at high risk for Lynch syndrome (LS), a hereditary cancer syndrome predisposing carriers to increased risk of colorectal, endometrial, and other cancers. To inform planning of a universal tumor screening program for LS in our jurisdiction, we undertook online surveys of Canadian pathologists and genetic counselors to describe existing tumor screening programs. Online surveys were hosted on SurveyMonkey between October 2016 and March 2017. Fifty-three pathologists and 66 genetic counselors completed surveys (total n = 119). While attitudes towards tumor screening were positive, considerable variability was observed in the existence of tumor screening, test ordering criteria, and practices. Most respondents indicated consent was not obtained for tumor screening nor were educational materials provided to patients; however, opting out of additional mutation testing in the event of a positive tumor screen was endorsed. Results add to the growing literature on providers' perspectives on population-based tumor screening programs and inform ways to offer these. Findings highlight the need to develop methods of patient education that allow meaningful opt-out decisions. The variability we observed also suggests the need for national standards and guidance on tumor screening for LS.