[Metastasis to the lateral skull base]. / Metastase eines Trachealkarzinoms im Bereich der Felsenbeinspitze.

BACKGROUND: Tumours and metastases of the lateral skull base are rare findings. Clinically, the progressive involvement of ipsilateral cranial nerves is important. CASE REPORT: A 69-year-old man presented with headache and palsies of the facial nerve and nerve VI. Furthermore, he had hearing loss and hypaesthesia of the trigeminal nerve (V3). Four months previously, laser therapy for carcinoma of the trachea (cT4 cN3 cM0) had been done. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an intrapetrosal mass with destruction of the lateral skull base. The findings suggested a metastasis of the tracheal carcinoma. We performed a mastoidectomy with specimen collection, and the pathological analysis revealed infiltration of a squamous cell carcinoma. The patient died within 3 weeks after radiotherapy with palliative intention despite malignant progression. CONCLUSION: The diagnosis and therapy of metastases to the lateral skull base is an interdisciplinary challenge. CT and MRI scans are essential for planning further procedures. In cases of headache and cranial nerve palsies, a metastasis to the lateral skull base must be considered in the differential diagnosis.

Cerebral heterotopia appearing as an extranasal polyp.

Cerebral heterotopia represents a rare tumorlike lesion related in its development to the encephaloceles but differing from these by non-connection to the cranial cavity. We describe an unusual case of cerebral heterotopia appearing as a pedunculated polyp on the upper lip of a newborn. As the distinction between encephaloceles and cerebral heterotopias is based on the correlation of radiologic and clinical findings, the surgical treatment of tumorlike lesions of the nasal and pharyngeal region in children requires a careful preoperative evaluation of their possible connection to the cranial cavity.

Familial arhinia, choanal atresia, and microphthalmia.

We describe two females (aunt and niece) with variable manifestations of arhinia, choanal atresia, microphthalmia, and hypertelorism. In the literature there is only one report on this syndrome in sibs. We hypothesize autosomal dominant inheritance with reduced penetrance.

[Rare inflammatory reactions in infants and their correlation with pathomorphologic alterations of the immune system]. / Seltene Entzündungsreaktionen im Kindesalter und ihre Korrelation mit pathomorphologischen Befunden am Immunsystem.

Autopsy-findings in infants with rare inflammatory disorders or infectious diseases esp. opportunistic infections may suggest defects of the unspecific and specific defence. The histopathological appearances of different lesions were correlated with possible underlying alterations or generalized defects of the immune system.

[Antepartal diagnosis of an acardius in a triplet pregnancy using ultrasound]. / Antepartale Diagnostik eines Acardius bei Drillingsschwangerschaft mittels Ultraschall.

In fetal anomalies we can follow the course by repeated ultrasound examinations and so decide the therapy. For collection of experience all rare cases should be published. Beginning in 25th gestational week we observed a triplet pregnancy, in which one fetus was a severe malformed acardius. Fetus I has been separated with an own placenta and was developing well. Fetus II had to supply the acardius with circulating blood and therefore it retarded beginning in the 28th week. Fetus III was the malformed acardius. Beginning in the 28th week it began to grow rapidly. Caused by this fact and an increasing hydramnios pregnancy was terminated by spontaneous delivery in 31th week. The normal fetus I (1320 g) survived. The retarded fetus II (830 g) died postnataly. The diagnosis of an acardius monster (triplet III, 2090 g) was confirmed by autopsy. Good collaboration with the pathologist is of great value, because he can show the clinician the degree of precision of his antenatal diagnosis.

[Morphology and differential histological diagnosis of BCG histiocytosis]. / Morphologie und histologische Differentialdiagnose der BCG-Histiozytose.

Two cases of mycobacterial histiocytosis in infants with the morphological signs of a combined immune defect are reported. In the first case the seven months aged male infant died of a generalized BCG infection. In the second case the mycobacterial histiocytosis of mesenterial lymph nodes was an incidental finding of autopsy in a female infant four month of age, whose cause of death was a generalized cytomegaly. The morphological picture and the histological differential diagnosis of mycobacterial histiocytosis are discussed.