RESUMO
We present two cases of Lymphoepithelial carcinoma (LEC) which were found in uncommon sites, the first at the right parotid salivary gland and the second at the base of the tongue. Both patients presented with painless neck masses and were diagnosed with histologic analysis. There is an association with Epstein-Barr virus (EBV) infection in the first case, but none was found in the second case. The primary and metastatic LEC are indistinguishable through histological studies. Therefore, examination of nasopharynx and neck imaging is vital to differentiate primary and metastatic LEC in non-nasopharyngeal sites. A collaboration between surgeons and pathologists is essential for accurate diagnosis of LEC. Radiotherapy is the main choice of treatment for LEC, similar to the cases in the nasopharynx.
RESUMO
Ceruminous glands are modified apocrine sweat glands that are situated in the cartilaginous segment of the external auditory canal. Ceruminous gland tumors only account for about 5% to 5.7% of all external ear tumors. Syringocystadenoma papilliferum (SCAP) is a slow-growing and benign neoplasm that originates from the apocrine or eccrine sweat glands. It is also the rarest of all ceruminous gland neoplasms and only accounts for 2% of these cases. This is the 19th reported case of SCAP in the external auditory canal in the English literature. The definite diagnosis of SCAP is confirmed histologically due to varied differentials from its clinical appearance. The mainstay treatment of SCAP is surgical excision of the tumor, in our case, we obtained an incisional biopsy to aid in the diagnosis and then proceeded with an excisional biopsy. The patient has no signs of tumor recurrence post-operatively. A detailed review of the clinical, radiographic, and histomorphological characteristics of SCAP is discussed.
RESUMO
Malignant transformation of recurrent respiratory papillomatosis (RRP) is a rare entity occurring in only less than 5% of patients with RRP. The risk of transformation can arise even in the absence of risk factors such as smoking and radiation. We describe a patient with juvenile RRP diagnosed since childhood, who suffered malignant transformation into a squamous cell carcinoma after 29 years. Keywords: Recurrent respiratory papillomatosis; laryngeal neoplasms; squamous cell carcinoma; human papilloma-virus.
Assuntos
Neoplasias Laríngeas , Papiloma , Infecções por Papillomavirus , Infecções Respiratórias , Transformação Celular Neoplásica , Criança , Humanos , Infecções por Papillomavirus/complicaçõesRESUMO
The cross sectional study was conducted in Universiti Kebangsaan Malaysia Medical Center (UKMMC), Malaysia from August 2012 to December 2013. All patients implanted with in UKMMC from December 2001 until December 2012 was included. Glasgow Benefit Inventory (GBI) questionnaires and UKMMC questionnaires were used as part of the assessment tool. The GBI is a scoring which measures the change in health status produced by surgical interventions. UKMMC questionnaires was invented by our department to assess questions related to social and life style of patients and also the cosmetic perspective Baha implant and other daily related activities. The audiological assessment was assessed using hearing aid gain threshold. Complication with regards to skin reaction was graded using Holger Skin Classification. A total of 40 patients underwent Baha implant were recruited but only 35 patients fulfilled the criteria and included in this study for analysis. Age of patients ranged from 5 year old to 38 year old, with median of 13 years old. There were 22 patients (62.8%) were male and 13 patients (37.1%) were females. Almost all cases were canal atresia except one adult patient was a case of bilateral chronic discharging ear with chronic irritation with ear mould. Majority of patients 21 (60%) have hearing level of moderate to severe hearing loss (40-89 dB) and 14 patients (40%) have mild to moderate hearing loss (20-39 dB). The level of hearing was retested post operatively. All of the patients have improvement in their aided hearing with the range of 10-25 dBL which is statistically significant at p value of <0.05. The GBI was scored positively in all subscales. Majority of patients (91.4%) used BAHA more than 4 h per day and 88.6% agreed that BAHA is cosmetically acceptable. All patients experienced some form of skin irritation (Holger grade 1-2) however only 20% required surgical intervention. All our patients have range of 10-25 dB improvement of their aided hearing which is statistically significant at p value of <0.05. BAHA has been proven to show significant benefit in audiological improvement and quality of life.
