Rhabdomyoma of the tonsillar fossa.

Extracardiac rhabdomyomas are very uncommon tumors comprising approximately 2% of the neoplasms of striated muscle origin. The adult extracardiac rhabdomyoma is generally characterized as a slowly growing, usually solitary lesion, which is nearly always found in the head and neck area of elderly persons. The most common reported head and neck subsites are the floor of the mouth, tongue, palate, lips, and cheeks. We report an unusual presentation of rhabdomyoma that should be included in the differential diagnosis of tumors presenting as a large tonsillar fossa mass. In our review of the almost 160 clinical notes reported in the literature, only 2 instances of tonsillar rhabdomyomas were found. The cytologic and immunohistochemical differential diagnoses of this tumor are also discussed.

Comparison of the long-term efficacy of subcutaneous and sublingual immunotherapies in perennial rhinitis.

BACKGROUND: Both sublingual and subcutaneous immunotherapies have a documented clinical efficacy, but only a few comparative studies have been performed. OBJECTIVES: To evaluate and compare the long-term efficacies of subcutaneous and sublingual immunotherapy. METHODS: One hundred and ninety-three patients with house dust mite allergies, out of an original total of 230, were treated with subcutaneous and sublingual house dust mite-specific immunotherapies for 3 years and also observed for 3 years after discontinuation of the treatment. The patients were randomized into 2 groups: the sublingual group (97 patients) and the subcutaneous group (96 patients). The therapy's success was evaluated using the symptom score, skin prick test results, and the nasal allergen challenge score. The patients were evaluated at the beginning of the study, at the end of years 1, 2, and 3, and also at the end of the 1st and 3rd years after discontinuation of the specific immunotherapy treatment. RESULTS: Immunotherapy induced a significant improvement during the treatment and the follow-up period. We found a greater improvement in the subcutaneous group compared to the sublingual group when we looked at the comparative results of the total 6 years. CONCLUSION: We suggest subcutaneous immunotherapy for patients with perennial allergic rhinitis due to the better results that were obtained during our study period. Nevertheless, sublingual immunotherapy is now accepted by WHO as a valid alternative to the subcutaneous route and should be used in all patients who require immunotherapy and do not accept the subcutaneous route of allergen administration.