BACKGROUND Sinonasal teratocarcinosarcoma(SNTCS)is a rare and highly invasive neoplasm originating from the nasal cavity and sinuses.Typically,it exhibits an invasive behavior towards adjacent structures;however,in ex...BACKGROUND Sinonasal teratocarcinosarcoma(SNTCS)is a rare and highly invasive neoplasm originating from the nasal cavity and sinuses.Typically,it exhibits an invasive behavior towards adjacent structures;however,in exceptional instances,it may infiltrate the intracranial compartment.Due to the tumor's rarity and lack of distinctive features on computed tomography(CT)and magnetic resonance imaging(MRI)images,SNTCS is often misdiagnosed.CASE SUMMARY In this study,we present a case of SNTCS in a 56-year-old patient who exhibited unexplained cognitive impairment before admission.CT and MRI scans revealed the presence of a mass in the right nasal cavity,with lesions extending to the right ethmoid sinus and right frontal region.Subsequently,the patient underwent pathological examination for confirmation and received surgical intervention to excise the tumor.The future advancement in our understanding of this disease will significantly contribute to the precise diagnosis and treatment of SNTCS.CONCLUSION SNTCS is an exceptionally rare malignant tumor that originates from the nasal cavity and paranasal sinuses,presenting a diagnostic challenge due to its nonspecific imaging findings.MRI accurately delineates the location,morphological characteristics,size,internal structure,extent of surrounding involvement,and metabolic information of the lesion.These aspects play a pivotal role in the precise localization and qualitative assessment of SNTCS.Nevertheless,a definitive diagnosis still requires a pathological biopsy.展开更多
Small cell neuroendocrine carcinoma (SCNEC) of the paranasal sinuses is extremely rare,with an unclear pathogenesis.The presence of neuroendocrine granules is suggestive of neuroendocrine differentiation.It was report...Small cell neuroendocrine carcinoma (SCNEC) of the paranasal sinuses is extremely rare,with an unclear pathogenesis.The presence of neuroendocrine granules is suggestive of neuroendocrine differentiation.It was reported that this disease relates to the presence of accessory salivary glands,and some basic research has shown that it might originate from the multi-potent stem cells.There are no specific clinical symptoms but rhinal and ophthalmological symptoms are found in most cases.Diagnosis mainly depends on histopathological manifestations,immunohistochemical results and features of the electron microscopic ultra-structure.Pathological differentiation from poorly differentiated squamous carcinoma,melanoma,esthesioneuroblastoma and neuroglioma etc.is needed.No unified regimen has been employed in treating the disease.At present,combined therapy has a manifest therapeutic effect,such as success with the 2003 French regimen.Tumor relapse is common and prognosis is poor.A complete combined treatment plan will be helpful to improve the prognosis.展开更多
Primary mucosal melanoma of the paranasal sinuses is a rare tumor of the head and neck which can be a devastating disease.Cancers arising in the sinonasal cavity are extremely rare,with a poor survival rate.There is i...Primary mucosal melanoma of the paranasal sinuses is a rare tumor of the head and neck which can be a devastating disease.Cancers arising in the sinonasal cavity are extremely rare,with a poor survival rate.There is inherent difficulty in diagnosing these lesions due to their complex anatomic locations and symptoms which are often confused with more common benign processes.The primary treatment of this rare disease process is resection,except in advanced stages where surgical resection is not an option.Diagnostic accuracy in consideration of size,location,and presence of metastatic disease of these malignant tumors tailors individual patients to different management in order to achieve the longest possible survival.展开更多
BACKGROUND Lung cancer is often metastasized to the brain,liver,kidneys,bone,bone marrow,and adrenal glands;however,metastasis of primary lung cancer to the paranasal sinuses is extremely rare.CASE SUMMARY In this pap...BACKGROUND Lung cancer is often metastasized to the brain,liver,kidneys,bone,bone marrow,and adrenal glands;however,metastasis of primary lung cancer to the paranasal sinuses is extremely rare.CASE SUMMARY In this paper,we present a case of metastatic tumors of the sinus secondary to lung adenocarcinoma.The patient was a 46-year-old woman who underwent surgical removal of lung carcinoma.Four months after the surgical removal of the lung tumor,the patient presented with epistaxis,and on investigation,the diagnosis was confirmed to be nasal sinus tumors due to metastasis of lung adenocarcinoma.CONCLUSION Thorough investigation of patients with epistaxis and a history of lung cancer is necessary to diagnose metastatic sinus tumors.We reviewed relevant literature and found that there are no characteristic clinical or radiologic features for metastatic sinus tumors;however,the diagnosis can be confirmed by histopathological examination of biopsied tumor sample.展开更多
Objective： The aim of the study was to study the nuclear magnetic resonance image （MRI） feature for involvement of paranasal sinuses in patients with nasopharyngeal carcinoma （NPC）. Methods： The MRI of 56 patien...Objective： The aim of the study was to study the nuclear magnetic resonance image （MRI） feature for involvement of paranasal sinuses in patients with nasopharyngeal carcinoma （NPC）. Methods： The MRI of 56 patients with NPC and paranasal sinuses infringed were evaluated between December 2003 and August 2004. Results： Among them, 56 （100%） showed breakage in the wall of paranasal sinuses, 29 （51.8%） had thick mucous membrane in sinuses, 36 （64.3%） showed tumour invasion sinuses, 55 （98.2%） connected with primary carcinoma with the lesion, and 14 （25%） stored up fluid in si- nuses. On MRI scan technique, the positive ratios of diagnoses were 66.1%, 76.8%, and 98.2% respectively （P 〈 0.000） in the horizontal section, coronal section and sagittal section. And nearly 60% was in the TlWl and T2Wl, but 100% in strengthen scan. Conclusion： The findings of sinuses wall breakage, thick mucous membrane in sinuses, tumour invasion cavity connective mass, and same enhancement signal in MR image may indicate the paranasal sinuses involved by primary turnout. The sagittal section and enhanced MRI scans are helpful to diagnosis.展开更多
Objective: The aim of this study was to evaluate intra- and inter-observer reproducibility of sinus x-rays in comparison to sinus computed tomography (CT) in chronic rhinosinusitis (CRS) patients. Methods: This was a ...Objective: The aim of this study was to evaluate intra- and inter-observer reproducibility of sinus x-rays in comparison to sinus computed tomography (CT) in chronic rhinosinusitis (CRS) patients. Methods: This was a prospective controlled study for which 14 adult CRS patients were recruited. Patients underwent a sinus multi-detector CT scan as well as additional sinus x-rays at the same time. Symptom interview and skin prick tests were performed. Lund-Mackay (LM) scores and 43 other findings in paranasal sinuses were analyzed by three blinded observers from CT-scans and x-rays. We compared agreement between sinus CT and x-rays (intra-observer reproducibility) and between three observers (inter-observer reproducibility) by Cohen’s kappa. Results: In at least 90% of the cases, the status of 47/49 structures was detectable in CT scans, whereas the status of only 8/49 structures was detectable in x-rays. The majority of the 25 visualized structures had poor intra-observer and inter-observer reproducibility. Conclusion: Only a few structures can be visualized in paranasal sinus x-rays and compared to paranasal sinus CT-scans, their reproducibility is poor. Our results strongly support the current consensus of radiation dose reduction by limiting the number of x-rays.展开更多
The inverted papilloma is an uncommon unilateral benign unilateral tumor of the nose & paranasal sinuses. Although a benign pathology, it is associated with aggressive local destruction and recurrence after remova...The inverted papilloma is an uncommon unilateral benign unilateral tumor of the nose & paranasal sinuses. Although a benign pathology, it is associated with aggressive local destruction and recurrence after removal and malignancy. The clinical picture presents non-specific signs and symptoms, such as unilateral nasal obstruction, anosmia and headache. Treatment is essentially surgical. This report has the objective of presenting an uncommon bilateral nasal inverted papilloma and the use of diode laser in surgical excision & making a literature review. The uniqueness in our case was the use of diode laser in excision of inverted papilloma.展开更多
Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this pros...Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this prospective study was to evaluate whether this study method might be eligible in studies aiming at radiation dose reduction. Sinus CT scans were chosen as a model because of the high variation of the radiological anatomy of surgically important sinonasal structures. We hypothesized that 3 mm-slice-thick reconstruction CT had poor reproducibility. Methods: 59 CRS patients underwent routine multi-detector sinus CT (CT<sub>MD</sub>). CT<sub>3mm</sub> was reconstructed from CT<sub>MD</sub> data-sets. Lund-Mackay (LM) scores and 43 other structural parameters were analyzed blinded. Agreement was studied between CT<sub>MD</sub> and CT<sub>3mm</sub> (intra-observer reproducibility), and between three observers (inter-observer reproducibility) by using Cohen’s kappa. Results: The inter-observer agreement was moderate (kappa 0.4 - 0.6, p < 0.01) in the majority of structures of CT<sub>3mm</sub> scans. The intra-observer reproducibility of CT<sub>3mm</sub> scans was very good in most structures, however, it was poor in important structures such as frontal and spheno-ethmoid recess, lamina papyracae, and location of optic nerve or anterior ethmoidal artery. The grade of surgeon’s confidence of CT<sub>3mm</sub> in comparison to CT<sub>MD</sub> was lower (kappa 0.2 - 0.4, P < 0.05). Conclusion: This methodology might have some use in studies aiming at radiation dose reduction. As was expected, 3 mm-slice-thick reconstruction CT had poor reproducibility and surgeon’s confidence. More recent methods such as cone beam computed tomography scans have nowadays more relevant dose reduction potential.展开更多
<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacen...<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacent structures, serious morbidities and mortalities may occur. <strong>Objective:</strong> To emphasize on the efficacy of endonasal endoscopic marsupialization in the treatment of paranasal sinus mucoceles. <strong>Method:</strong> Retrospective descriptive study on paranasal sinus mucocele cases operated on endoscopically by the author (AAM), in the 10-year-period from to 2009-2019. <strong>Result:</strong> Total of 23 cases were included, 16 were males and 7 females, age ranging between 14 - 76 years, with a mean age of 45 years Location of mucoceles varied between: Frontal 7 cases (30%), Fronto-ethmoidal 6 cases (26%), Isolated Ethmoidal accounted for 3 cases (13%), sphenoidal 4 cases (17%), maxillary were 3 cases (13%) all of the 23 cases underwent endonasal endoscopic complete marsupialization, none of them required combination with external approach in-spite of different locations and complications, with no recurrence in a mean follow up period of 2.4 years. <strong>Conclusion:</strong> Endonasal endoscopic approach is a safe, efficient approach in the treatment of most paranasal sinus mucocele case in their different presentations and locations.展开更多
BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and ...BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.展开更多
恶性淋巴瘤是头颈部仅次于鳞状细胞癌癌的高发恶性肿瘤,鼻型结外淋巴瘤90%以上为NK/T细胞来源,原发于鼻腔鼻窦的弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma,DLBCL）少见。本文回顾分析2010年3月～2017年9月收治于北京海军总医...恶性淋巴瘤是头颈部仅次于鳞状细胞癌癌的高发恶性肿瘤,鼻型结外淋巴瘤90%以上为NK/T细胞来源,原发于鼻腔鼻窦的弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma,DLBCL）少见。本文回顾分析2010年3月～2017年9月收治于北京海军总医院耳鼻咽喉头颈外科4例原发于鼻腔鼻窦的弥漫大B细胞淋巴瘤病例资料。1临床资料患者均为老年人,年龄58～70岁,男性3例,女性1例。展开更多
文摘BACKGROUND Sinonasal teratocarcinosarcoma(SNTCS)is a rare and highly invasive neoplasm originating from the nasal cavity and sinuses.Typically,it exhibits an invasive behavior towards adjacent structures;however,in exceptional instances,it may infiltrate the intracranial compartment.Due to the tumor's rarity and lack of distinctive features on computed tomography(CT)and magnetic resonance imaging(MRI)images,SNTCS is often misdiagnosed.CASE SUMMARY In this study,we present a case of SNTCS in a 56-year-old patient who exhibited unexplained cognitive impairment before admission.CT and MRI scans revealed the presence of a mass in the right nasal cavity,with lesions extending to the right ethmoid sinus and right frontal region.Subsequently,the patient underwent pathological examination for confirmation and received surgical intervention to excise the tumor.The future advancement in our understanding of this disease will significantly contribute to the precise diagnosis and treatment of SNTCS.CONCLUSION SNTCS is an exceptionally rare malignant tumor that originates from the nasal cavity and paranasal sinuses,presenting a diagnostic challenge due to its nonspecific imaging findings.MRI accurately delineates the location,morphological characteristics,size,internal structure,extent of surrounding involvement,and metabolic information of the lesion.These aspects play a pivotal role in the precise localization and qualitative assessment of SNTCS.Nevertheless,a definitive diagnosis still requires a pathological biopsy.
文摘Small cell neuroendocrine carcinoma (SCNEC) of the paranasal sinuses is extremely rare,with an unclear pathogenesis.The presence of neuroendocrine granules is suggestive of neuroendocrine differentiation.It was reported that this disease relates to the presence of accessory salivary glands,and some basic research has shown that it might originate from the multi-potent stem cells.There are no specific clinical symptoms but rhinal and ophthalmological symptoms are found in most cases.Diagnosis mainly depends on histopathological manifestations,immunohistochemical results and features of the electron microscopic ultra-structure.Pathological differentiation from poorly differentiated squamous carcinoma,melanoma,esthesioneuroblastoma and neuroglioma etc.is needed.No unified regimen has been employed in treating the disease.At present,combined therapy has a manifest therapeutic effect,such as success with the 2003 French regimen.Tumor relapse is common and prognosis is poor.A complete combined treatment plan will be helpful to improve the prognosis.
文摘Primary mucosal melanoma of the paranasal sinuses is a rare tumor of the head and neck which can be a devastating disease.Cancers arising in the sinonasal cavity are extremely rare,with a poor survival rate.There is inherent difficulty in diagnosing these lesions due to their complex anatomic locations and symptoms which are often confused with more common benign processes.The primary treatment of this rare disease process is resection,except in advanced stages where surgical resection is not an option.Diagnostic accuracy in consideration of size,location,and presence of metastatic disease of these malignant tumors tailors individual patients to different management in order to achieve the longest possible survival.
文摘BACKGROUND Lung cancer is often metastasized to the brain,liver,kidneys,bone,bone marrow,and adrenal glands;however,metastasis of primary lung cancer to the paranasal sinuses is extremely rare.CASE SUMMARY In this paper,we present a case of metastatic tumors of the sinus secondary to lung adenocarcinoma.The patient was a 46-year-old woman who underwent surgical removal of lung carcinoma.Four months after the surgical removal of the lung tumor,the patient presented with epistaxis,and on investigation,the diagnosis was confirmed to be nasal sinus tumors due to metastasis of lung adenocarcinoma.CONCLUSION Thorough investigation of patients with epistaxis and a history of lung cancer is necessary to diagnose metastatic sinus tumors.We reviewed relevant literature and found that there are no characteristic clinical or radiologic features for metastatic sinus tumors;however,the diagnosis can be confirmed by histopathological examination of biopsied tumor sample.
文摘Objective： The aim of the study was to study the nuclear magnetic resonance image （MRI） feature for involvement of paranasal sinuses in patients with nasopharyngeal carcinoma （NPC）. Methods： The MRI of 56 patients with NPC and paranasal sinuses infringed were evaluated between December 2003 and August 2004. Results： Among them, 56 （100%） showed breakage in the wall of paranasal sinuses, 29 （51.8%） had thick mucous membrane in sinuses, 36 （64.3%） showed tumour invasion sinuses, 55 （98.2%） connected with primary carcinoma with the lesion, and 14 （25%） stored up fluid in si- nuses. On MRI scan technique, the positive ratios of diagnoses were 66.1%, 76.8%, and 98.2% respectively （P 〈 0.000） in the horizontal section, coronal section and sagittal section. And nearly 60% was in the TlWl and T2Wl, but 100% in strengthen scan. Conclusion： The findings of sinuses wall breakage, thick mucous membrane in sinuses, tumour invasion cavity connective mass, and same enhancement signal in MR image may indicate the paranasal sinuses involved by primary turnout. The sagittal section and enhanced MRI scans are helpful to diagnosis.
文摘Objective: The aim of this study was to evaluate intra- and inter-observer reproducibility of sinus x-rays in comparison to sinus computed tomography (CT) in chronic rhinosinusitis (CRS) patients. Methods: This was a prospective controlled study for which 14 adult CRS patients were recruited. Patients underwent a sinus multi-detector CT scan as well as additional sinus x-rays at the same time. Symptom interview and skin prick tests were performed. Lund-Mackay (LM) scores and 43 other findings in paranasal sinuses were analyzed by three blinded observers from CT-scans and x-rays. We compared agreement between sinus CT and x-rays (intra-observer reproducibility) and between three observers (inter-observer reproducibility) by Cohen’s kappa. Results: In at least 90% of the cases, the status of 47/49 structures was detectable in CT scans, whereas the status of only 8/49 structures was detectable in x-rays. The majority of the 25 visualized structures had poor intra-observer and inter-observer reproducibility. Conclusion: Only a few structures can be visualized in paranasal sinus x-rays and compared to paranasal sinus CT-scans, their reproducibility is poor. Our results strongly support the current consensus of radiation dose reduction by limiting the number of x-rays.
文摘The inverted papilloma is an uncommon unilateral benign unilateral tumor of the nose & paranasal sinuses. Although a benign pathology, it is associated with aggressive local destruction and recurrence after removal and malignancy. The clinical picture presents non-specific signs and symptoms, such as unilateral nasal obstruction, anosmia and headache. Treatment is essentially surgical. This report has the objective of presenting an uncommon bilateral nasal inverted papilloma and the use of diode laser in surgical excision & making a literature review. The uniqueness in our case was the use of diode laser in excision of inverted papilloma.
文摘Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this prospective study was to evaluate whether this study method might be eligible in studies aiming at radiation dose reduction. Sinus CT scans were chosen as a model because of the high variation of the radiological anatomy of surgically important sinonasal structures. We hypothesized that 3 mm-slice-thick reconstruction CT had poor reproducibility. Methods: 59 CRS patients underwent routine multi-detector sinus CT (CT<sub>MD</sub>). CT<sub>3mm</sub> was reconstructed from CT<sub>MD</sub> data-sets. Lund-Mackay (LM) scores and 43 other structural parameters were analyzed blinded. Agreement was studied between CT<sub>MD</sub> and CT<sub>3mm</sub> (intra-observer reproducibility), and between three observers (inter-observer reproducibility) by using Cohen’s kappa. Results: The inter-observer agreement was moderate (kappa 0.4 - 0.6, p < 0.01) in the majority of structures of CT<sub>3mm</sub> scans. The intra-observer reproducibility of CT<sub>3mm</sub> scans was very good in most structures, however, it was poor in important structures such as frontal and spheno-ethmoid recess, lamina papyracae, and location of optic nerve or anterior ethmoidal artery. The grade of surgeon’s confidence of CT<sub>3mm</sub> in comparison to CT<sub>MD</sub> was lower (kappa 0.2 - 0.4, P < 0.05). Conclusion: This methodology might have some use in studies aiming at radiation dose reduction. As was expected, 3 mm-slice-thick reconstruction CT had poor reproducibility and surgeon’s confidence. More recent methods such as cone beam computed tomography scans have nowadays more relevant dose reduction potential.
文摘<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacent structures, serious morbidities and mortalities may occur. <strong>Objective:</strong> To emphasize on the efficacy of endonasal endoscopic marsupialization in the treatment of paranasal sinus mucoceles. <strong>Method:</strong> Retrospective descriptive study on paranasal sinus mucocele cases operated on endoscopically by the author (AAM), in the 10-year-period from to 2009-2019. <strong>Result:</strong> Total of 23 cases were included, 16 were males and 7 females, age ranging between 14 - 76 years, with a mean age of 45 years Location of mucoceles varied between: Frontal 7 cases (30%), Fronto-ethmoidal 6 cases (26%), Isolated Ethmoidal accounted for 3 cases (13%), sphenoidal 4 cases (17%), maxillary were 3 cases (13%) all of the 23 cases underwent endonasal endoscopic complete marsupialization, none of them required combination with external approach in-spite of different locations and complications, with no recurrence in a mean follow up period of 2.4 years. <strong>Conclusion:</strong> Endonasal endoscopic approach is a safe, efficient approach in the treatment of most paranasal sinus mucocele case in their different presentations and locations.
文摘BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.
文摘恶性淋巴瘤是头颈部仅次于鳞状细胞癌癌的高发恶性肿瘤,鼻型结外淋巴瘤90%以上为NK/T细胞来源,原发于鼻腔鼻窦的弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma,DLBCL）少见。本文回顾分析2010年3月～2017年9月收治于北京海军总医院耳鼻咽喉头颈外科4例原发于鼻腔鼻窦的弥漫大B细胞淋巴瘤病例资料。1临床资料患者均为老年人,年龄58～70岁,男性3例,女性1例。
