[Safe extirpating of AFJ after preoperative tumor obliteration with tissue adhesive glue]. / Bezpieczne usuniecie AFJ po przedoperacyjnej obliteracji guza klejem tkankowym.

The purpose of this work is to present the method of operating juvenile nasopharyngeal angiofibroma with the use of preoperative obliteration with tissue adhesive glue (Histoacryl). Authors described the case of 15 years old patient, who was admitted to ENT Department because of epistaxis, nasal obturation and returning headaches. To explain this problem, the routine diagnostics CT and angio-CT scan was applicated. Angiography confirmed well vascularized tumor supplied from facial and palatine arteries. Therapy based on the obliteration of tumor vessels with the glue-tissue was applied. As the next step the tumour was surgically extirpated. The application of this method gave a very good, simply bloodless operation effects. It allows a very good, simple and fully precise tumor extirpation. The extirpation of AFJ which is a highly vascularized tumor with the previous obliteration of the supplying vessels is a safe procedure and results in complete removal of the tumour.

[Diagnostic and therapeutic difficulties in soft tissue sarcomas localized in nonparameningeal head and neck region--own experiences]. / Trudnosci diagnostyczne i terapeutyczne w przypadkach miesaków tkanek mieskkich zlokalizowanych w obrebie glowy i szyi u dzieci--doswiadczenia wlasne.

INTRODUCTION: Soft tissue sarcomas (MTM) localized within the nonorbital and non-parameningeal head and neck region in children are associated with favourable prognosis. However in our material we have observed many therapeutic failures in this group of patients. The aim of the study was to analyze the reasons for disappointing results of oncological therapy in children with MTM treated between 1992 and 2004. MATERIAL AND METHODS: Nine children (M/F: 6/3; mean age 5,5 years). Five patients were diagnosed with rhabdomyosarcoma, four--with non-rhlabdomyosarcoma, including: angiosarcoma, malignant triton tumour, fibrosarcoma and leiomyosarcoma. RESULTS: mean duration of initial symptoms was 7 months. The first sign of the neoplastic disease in all children was tumour. In as many as five of nine patients initially a false histopathological diagnosis was made based on material obtained from aspiration biopsy of the tumour performed in non-oncological centres. This resulted in a significant delay of the proper diagnosis of malignant disease ranging from 2 to 15 months (mean 7 months). That is why all our patients presented with highly advanced stages of MTM or even in the phase of disease recurrence. Therapy was conducted according to the schemes: MMT-89, CWS-91, CWS-96 and CWS-2002. Durable complete remission after the first line therapy was obtained in one child only. Six patients developed MTM relapse and two--progression during chemotherapy. Finally five children remain disease-free after treatment termination with follow-up of 1 to 1,5 years. Four of then had microscopically complete delayed resection of the tumour or the relapse. Four patients died of neoplasm recurrence and progression. In three of them the proper diagnosis was delayed significantly and they were diagnosed in the first or even second relapse of the tumour. CONCLUSION: Unfavourable course and treatment results in MTM located in nonorbital and nonparameningeal head and neck region in our patients result from initial wrong histopathological diagnosis and delayed therapy institution.