[Overexpression of p53 protein in epidermoid carcinoma of the pyriform sinus]. / Sobreexpresión de la proteína p53 en el carcinoma epidermoide de seno piriforme.

Mutation of the p53 protein may be the commonest genetic event in the development of malignant neoplasms in humans. We analyzed the immunohistological expression of p53 in tissue sections from 51 patients with squamous cell carcinoma of the pyriform sinus who were treated with surgery and postoperative radiotherapy. Overexpression of p53 was found in 37 (72.5%) tumors. No correlation was found between p53 overexpression and clinical and histopathological parameters. Recurrence and overall survival did not differ between p53-positive and p53-negative cases.

Prognostic value of histopathologic parameters and DNA flow cytometry in squamous cell carcinoma of the pyriform sinus.

A retrospective study of a group of 51 patients who underwent surgery for squamous cell carcinoma of the pyriform sinus was performed. Primary tumors and lymph nodes were reviewed histologically. The primary tumors were also examined by flow cytometry for DNA ploidy and cell cycle analysis. Sixteen (33%) of the cases were aneuploid and 64% had a moderate or high S-phase fraction. The overall 3-year survival rate was 49% (25/51). In the univariate analysis, tumor size, lymphatic invasion, inflammatory infiltrate, presence of lymph node metastases, clinical and histologic N status, size and number of lymph nodes involved, and presence of extracapsular extension all correlated with survival. When multivariate analysis was used, the only independent prognostic factors were tumor size, lymphatic invasion, and histologic N status. Ploidy and S-phase fraction did not contribute further prognostic information.

[Differential diagnosis of bilateral progressive sensorineural loss. A report of a case secondary to neurofibromatosis 2]. / Diagnóstico diferencial de la hipoacusia neurosensorial bilateral progressiva. A propósito de un caso secundario a neurofibromatosis tipo II.

Progressive bilateral sensorineural hearing loss (BSNHL) was the first manifestation of type II neurofibromatosis in a young patient with no family or personal history of neurofibromatosis. The differential diagnosis of BSNHL is described and a diagnostic protocol is proposed.

[Nasal sinus adenocarcinoma in patients exposed to wood dust in the Community of Cantabria, Spain]. / Adenocarcinomas nasosinusales en pacientes expuestos al polvo de madera en la Comunidad de Cantabria.

OBJECTIVE: To study the incidence and clinical and histological features of sawdust-related nasosinusal adenocarcinoma (SRNA) in the Community of Cantabria. MATERIAL AND METHODS: A retrospective study was made of all patients diagnosed as SRNA in 9 years. RESULTS: Ten male patients, ranging in age from 56 to 64 years, were diagnosed as SRNA in this period. The most common location was the ethmoid. Histologically, six tumors were papillary and four were mucinous. Five patients received combined treatment (surgery and postoperative radiotherapy), one surgery alone, two radiotherapy, and one chemotherapy. The 5-year survival rate was 28.5%. The most frequent cause of death was local recurrence. CONCLUSIONS: The incidence of SRNA in the Community of Cantabria is less than 0.2 cases per 100,000 inhabitants/year. SRNA occurs almost exclusively in men and has an occupational origin. Papillary adenocarcinoma is the most frequent histological type. The treatment of choice is surgery associated with postoperative radiotherapy. The long-term prognosis is poor, so preventive measures to reduce exposure to sawdust are fundamental in risk groups.

[Rendu-Osler-Weber disease (hereditary hemorrhagic telangiectasia). Report of 30 cases]. / La enfermedad de Rendu-Osler-Weber (telangiectasia hemorrágica hereditaria). Presentación de 30 casos.

OBJECTIVE: To study the prevalence and modes of presentation of hereditary hemorrhagic telangiectasia (HHT) in Cantabria, Spain. MATERIALS AND METHODS: A retrospective study was made of all patients diagnosed as HHT in Cantabria in the last 20 years (1976-1995). The presence/absence of family history, recurrent nosebleed, mucosal and cutaneous telangiectasia, visceral involvement, and course of the disease were evaluated. RESULTS: Thirty patients ranging in age from 17 to 75 years were diagnosed as HHT in the study period. Most of them had a family history of recurrent nasal bleeding. The main symptom was nosebleed. Pulmonary arteriovenous fistulas were found in 7 patients and gastrointestinal manifestations in 10 patients. Five patients died of complications directly attributable to the disease. CONCLUSIONS: The minimum prevalence of HHT in Cantabria is 1:12,200, Patients with recurrent nosebleed, particularly if a family history of epistaxis is present, should undergo exploration of the oral cavity for telangiectasia. Early diagnosis of HHT can help to avoid unnecessary diagnostic procedures and contribute to the early detection of associated visceral malformations. The treatment of HHT should be individualized.

Mucormycosis of the sphenoid sinus in an otherwise healthy patient. Case report and literature review.

Paranasal and rhinocerebral mucormycosis refers to uncommon opportunistic fungal infections, reported to occur especially in association with diabetic acidosis (the most common), immunosuppressive therapy, malignancy, or other chronic debilitating disorders. However, patients who have no underlying disease have occasionally been affected. According to the literature reviewed, only 13 well-documented cases without any predisposing factor have been previously reported. We describe a unique case of sphenoidal mucormycosis in an otherwise healthy individual, and the first patient to present with headache as the only symptom. We emphasize the importance of a high index of suspicion for early diagnosis and prompt management.

[Simultaneous bilateral facial paralysis]. / Parálisis facial bilateral simultánea.

Simultaneous bilateral facial paralysis (SBFP) is very rare, but it can present itself as the first complaint in a wide spectrum of diseases and a comprehensive evaluation must be completed. Bilateral Bell's Palsy can be diagnosed only when all other possible causes have been excluded. The prognosis and treatment for SBFP is dependent upon the underlying etiology. We present four cases of SBFP seen in our department which were finally diagnosed as leukemic infiltration, sarcoidosis, Bell's Palsy and demyelinating polyneuropathy (probably Guillain-Barré syndrome). The most important etiologies of the SBFP and the management of this entity are discussed.

[Sphenoidal metastasis of laryngeal carcinoma]. / Metástasis esfenoidal de un carcinoma de laringe.

Metastatic tumors to the nose and paranasal sinuses are very uncommon and metastases to the sphenoid sinus are exceedingly rare. The most common tumor sites from which sphenoid metastases arise are the kidney and the lung. Distant metastases from laryngeal carcinoma are rare, the most common sites being the lungs, skeletal system, and liver. We report a patient with a supraglottic laryngeal carcinoma who had metastases to the sphenoid sinus. The management of this entity is described and cases reported in the literature are reviewed.

[Cholesterol granuloma of the petrous apex]. / Granuloma de colesterol de punta de peñasco.

Cholesterol granuloma of the petrous apex is an inflammatory granulation tissue response to the presence of cholesterol crystals. It is not generally associated with middle-ear pathology. CT and MRI are fundamental for diagnosis. MRI is more specific and shows a well-circunscribed mass with high signal intensity on both T1 and T2 weighted images. We present a case of cholesterol granuloma of the petrous apex that was previously diagnosed as cholesteatoma. We emphasize the importance of preoperatory differentiation of the lesion from cholesteatoma. Cholesterol granuloma does not require full excision of the lesion. Drainage and permanent aeration is usually sufficient.