When is a biopsy justified in a case of relapsing polychondritis?

Relapsing polychondritis (RP) is a relatively rare rheumatic condition of unknown aetiology. It is characterized by recurrent episodic inflammation of cartilaginous structures (nose, ear and trachea). The clinical diagnosis of polychondritis can frequently be made with confidence in the absence of histological confirmation. A 61-year-old diabetic man, with bilateral relapsing aural inflammation, left ear deafness with tinnitus and pain at the sternocostal junctions is reported. After clinical diagnosis of relapsing polychondritis steroid therapy was started. An ear cartilage biopsy was performed confirming the clinical diagnosis. Subsequently soft tissue infection occurred at the operation site. The abscess was drained and oral ciprofloxacin was given with complete resolution of the infection over 30 days. As the infection is the main cause of death in these patients, we analyse whether biopsy is absolutely necessary for the diagnosis of RP in some patients.

[Tuberculosis of the cavum]. / Tuberculosis de cávum.

An elderly woman had a history of hemimandibulectomy for mandibular ameloblastoma performed 24 years earlier. In the last follow-up visit, an excrescent and ulcerative lesion was detected in the posterior wall of the cavum, below and medial to Rosenmüller's fossa, with clamps of enlarged, consistent cervical lymph nodes that was more marked on the right side. Cavum biopsy and needle biopsy of the lymph nodes revealed tuberculosis. This diagnosis usually is incidental and the differential diagnosis includes tumoral and granulomatous processes. Biopsy of the cavum is important for regional lesions with cervical lymph node enlargement.

[Glomus jugulare tumor. Apropos of 2 cases]. / Glomus yugular. A propósito de dos casos.

We present two clinical cases of jugular glomus in which different kinds of treatment have been adopted. In literature we can find a review of the utility and morbidity of the different methods of exploration as well as the results obtained by the different authors according to the kind of treatment. Nevertheless we don't come to definite conclusions due to the fact that the classifications and curing criteria very in the different series.

[Extracranial primary meningioma. Presentation of a case of nasoethmoid localization]. / Meningiomas primarios extracraneales. Presentación de un caso de localización nasoetmoidal.

A case is presented of primary meningioma situated in the right nasal ethmoid. Clinical and radiological studies, as well as histopathological and ultrastructural examinations of the piece to be operated upon confirm definite diagnosis. The word is concluded by a bibliographical revision of the subject.