Undifferentiated pleomorphic sarcoma in oropharyngeal mucosa of patients with multiple basal cell carcinomas.

Malignant mesenchymal tumors of oropharyngeal mucosa are rare. Those with fibroblastic and histiocytic differentiation in the skin are called atypical fibroxanthoma (AFX) and in the soft tissue undifferentiated pleomorphic sarcoma (UPS). Here we present a case of an older patient with a history of multiple basal cell carcinomas and recently with a rapidly growing polypoid lesion in the mucosa of posterior oropharyngeal wall with AFX/UPS morphology. The differential diagnosis, histological pitfalls of this poorly characterized mesenchymal lesions, and the challenges associated with treatment are discussed.

Fine needle aspiration cytology in the evaluation of parotid gland tumors.

Main objective of this study was to evaluate the usefulness and accuracy of fine needle aspiration cytology (FNAC) diagnosis of parotid masses to distinguish reliably between benign and malignant lesions. In the period of 5 years, 214 parotid glands were resected at the Rijeka University Hospital Center (Croatia), but 176 patients had cytopathological and histopathological diagnoses and therefore fulfilled the criteria for study. The results of the FNAC were analyzed and compared to the corresponding histopathological diagnosis obtained from the surgical specimen. Histological evaluation revealed 17malignant and 159 benign lesions. There were 13 true positive, 147 true negative, 3 false negative, and 13 false positive. Sensitivity of FNAC was 81%, and specificity was 98%. FNAC results provide useful predictive preoperative information and better preparation the surgeon and patient for surgical procedure.

Neurectomy of the trigeminal nerve branches: clinical evaluation of an "obsolete" treatment.

INTRODUCTION: After all options of conservative treatment of trigeminal neuralgia have been exhausted, surgical methods are used. Peripheral neurectomy is one of the simplest among them. It is a relatively obsolete method, but can still be useful and effective. AIMS: To analyse the remission period after repetitive neuroexeresis of the same neural branch, to calculate "predicted" remission, and to evaluate the benefits of repetitive neuroexeresis. PATIENTS AND METHODS: Total of 85 neurectomies were performed in 36 patients in 5 years by intraoral access. The recurrence time was analysed by simple regression analysis, using the method of the least-squares. Thus, the average pain free time after repetitive neurectomy can be predicted. RESULTS: After the first operation on the infraorbital nerve, recurrence mainly appeared in the period between 12 and 15 months, after the second between 9 and 12 months. After the first operation on the mandibular nerve, recurrence took place mainly after 15-18 months, after the second 12.3 months on the average. No interventions were performed on the first branch. Calculated prediction of the average time of remission was in agreement with the actual duration of painlessness. CONCLUSION: Remission time after repetitive neurectomy decreases. There is no point in repeating the surgery on the same neural branch more than three times.