A rare case of carcinosarcoma of the maxillary sinus with osteosarcomatous differentiation.

A unique case of carcinosarcoma in the maxillary sinus is reported. A 47-year-old man visited our hospital with complaints of right nasal obstruction and bloody rhinorrhea. Examination revealed a hemorrhagic mass with necrosis in the maxillary sinus that infiltrated the right nasal cavity. Histologically, the tumor was composed of both carcinomatous and sarcomatous elements. Nests of squamous cell carcinoma and adenocarcinoma were scattered in the sarcomatous element with osteosarcomatous differentiation. No distinct demarcation between the two elements was observed and some spindle-shaped cells in the sarcomatous component were immunoreactive to epithelial markers by immunohistochemical staining. Although the histogenesis of carcinosarcoma remains unclear, the histologic pattern of the present case indicates the possibility that a multipotential cell, capable of both epithelial and mesenchymal differentiation, was the origin of the rare tumor.

[Evoked oto-acoustic emissions in patients with secretory otitis media].

In many studies, Evoked Otoacoustic Emissions (EOAEs) have been routinely documented in subjects with normal middle ear function showing tympanogram (TG) A type. However, middle ear dysfunction may influence the measurements of EOAEs. We investigated the EOAEs in ears with secretory otitis media (SOM) in order to understand the effects of middle ear dysfunction on EOAE measurements. We present data from 73 SOM ears of 38 subjects aged 3 to 58 (mean = 9.4 years) and data from 61 ears of 54 subjects with sensorineural hearing loss as a control. Generally, the EOAE thresholds of ears with mild sensorineural hearing loss have a good correlation with the audiometric hearing threshold level. On the other hand, the EOAE thresholds of ears with SOM were on the average higher than those expected from the audiometric hearing threshold level. In this paper, we classified TG B type further into TG B1 type and TG B2 type according to our criteria. Though neither TG B1 type nor TG B2 type revealed peaks in the tympanogram (-300mmH2O < or = < or = 200mmH2O), the 2 groups differ in that TG B1 type seems to have its peak at pressures under -300mmH2O on tympanography while TG B2 type seems to have no peaks in that pressure range. As a consequence of this classification, most of the EOAE thresholds of SOM ears showing TG B2 type were scaled out (> or = 40 or 50 dB nHL).(ABSTRACT TRUNCATED AT 250 WORDS)