Dear Sir,Iam Dr.Yin-Hung Chang from the Department of Otolaryngology,Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation.I would like to present a case of inverted papilloma with carcinoma change of lacrim...Dear Sir,Iam Dr.Yin-Hung Chang from the Department of Otolaryngology,Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation.I would like to present a case of inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity that had been successfully treated by endoscopic surgery.Lacrimal drainage apparatus tumors are rare but important展开更多
Objective: This paper reports a rare case of nasal glial heterotopia presenting as sphenochoanal polyp. So far, literature has revealed only few cases. Case Report: A 55-year-old woman presented with a 2-month history...Objective: This paper reports a rare case of nasal glial heterotopia presenting as sphenochoanal polyp. So far, literature has revealed only few cases. Case Report: A 55-year-old woman presented with a 2-month history of left sided nasal obstruction. Rigid endoscopy showed greyish left nasal polyp and anterior discharge. Subsequently, CT scan of the sinuses revealed sphenochoanal polyp filling the left nasal cavity, without signs of expansion, or destruction and no obvious connection with intracranial tissue. Mass was removed endoscopically and histology confirmed glial nature of the mass. Conclusion: Any mass arising from sphenoid sinus should be carefully evaluated on CT scan for existence of fibrous stalk, or connection with brain tissue and needs to be considered in the differential diagnosis of the sphenochoanal mass. Complete surgical excision is the treatment of choice, which is curative.展开更多
Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This ...Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This study aimed to evaluate whether magnetic resonance imaging （MRI）,including dynamic contrast enhanced MRI （DCE-MRI）,could improve differentiation between IP and malignant tumors,and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.Methods Non-enhanced,static,and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results.MRI features of IP and malignant tumors including side,margin,T1 signal intensity,T1 homogeneity,T2 signal intensity,T2 homogeneity,lobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,pattern of enhancement,Tpeak,Tmax,Clmax,and TIC type were evaluated and correlated with histological findings.Results There were significant differences between IP and malignant tumors in T2 homogeneity,Iobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,Tpeak,Tmax and TIC types.A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity.Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity.Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern,extra-sinonasal involvement,and washout-type TIC for both observers （Wang XY and Zhang ZY）.Conclusion Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.展开更多
Background Quantitative dynamic contrast enhancement MR imaging （DCE-MRI）,used to measure properties of tissue microvasculature and tumor angiogenesis,is a promising method for distinguishing benign and malignant tu...Background Quantitative dynamic contrast enhancement MR imaging （DCE-MRI）,used to measure properties of tissue microvasculature and tumor angiogenesis,is a promising method for distinguishing benign and malignant tumors and characterizing tumor response to antiangiogenic treatment.The aim of this study was to assess the feasibility of quantitative parameters derived from clinically used DCE-MRI for distinguishing benign from malignant tumors in the sinonasal area,which may be potentially useful for prediction and monitoring of treatment response to chemoradiotherapy of sinonasal tumors.Methods One hundred and forty-three patients with sinonasal tumors,including 78 malignant tumors and 65 benign tumors and tumor-like lesions,underwent clinically used DCE-MRI.Parametric maps were obtained for quantitative parameters including Ktrans,kep and ve.Two radiologists reviewed these maps and measured Ktrans,kep and ve in the tumor tissue.Data were analyzed using independent T-test or Mann-Whitney U test analysis and receiver operating characteristic curves.Results Ktrans,kep and ve showed significant differences between benign and malignant tumors in the sinonasal area （P=-0.000 1）.The accuracy of Ktrans,kep and ve in differentiation between benign and malignant sinonasal tumors were 72.0％,76.2％ and 67.1％,respectively.There were significant differences in kep and ve between malignant epithelial sinonasal tumors and lymphomas （P ＜0.05）.Using a ve value of 0.213 as the threshold value differentiated malignant epithelial tumors from lymphomas with an accuracy of 78.3％,sensitivity of 88.2％,specificity of 68.0％,positive predictive value of 66.7％,and negative predictive value of 90.9％.However,no significant difference in Ktrans and kep was found between malignant epithelial and non-epithelial tumors in the sinonasal area （P ＞0.05）.Conclusions It is feasible that quantitative parameters of tumors can be derived from clinically used DCE-MRI in the sinonasal region.Preliminary findings suggest an increased value for quantitative DCE-MRI in the evaluation of sinonasal tumors in clinical practice.展开更多
Objective:We present the largest population based study of sinonasal squamous cell carcinoma(SCC)to identify risk factors for presentation with nodal metastasis.Methods:The National Cancer Database(NCDB)was used for t...Objective:We present the largest population based study of sinonasal squamous cell carcinoma(SCC)to identify risk factors for presentation with nodal metastasis.Methods:The National Cancer Database(NCDB)was used for this study.Location codes corresponding to the nasal cavity and paranasal sinuses and histology codes representing SCC malignancy were queried.Logistic regression analysis was performed to identify factors associated with presentation with nodal metastasis.Results:6448 cases met inclusion criteria.Nodal metastasis at presentation was seen in 13.2%of patients,with the sinus subsite(19.3%)being a significant risk factor for nodal metastasis at presentation when compared to the nasal cavity(7.9%).Logistic regression analysis showed black,uninsured and Medicaid patients were more likely than white and privately insured patients,respectively,to present with nodal metastasis.Conclusions:In sinonasal SCC,the sinus subsite has a significantly increased risk of nodal metastasis compared to the nasal cavity.Black race,uninsured and Medicaid patients are more likely to have nodal metastasis at presentation.展开更多
基金Supported by Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation
文摘Dear Sir,Iam Dr.Yin-Hung Chang from the Department of Otolaryngology,Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation.I would like to present a case of inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity that had been successfully treated by endoscopic surgery.Lacrimal drainage apparatus tumors are rare but important
文摘Objective: This paper reports a rare case of nasal glial heterotopia presenting as sphenochoanal polyp. So far, literature has revealed only few cases. Case Report: A 55-year-old woman presented with a 2-month history of left sided nasal obstruction. Rigid endoscopy showed greyish left nasal polyp and anterior discharge. Subsequently, CT scan of the sinuses revealed sphenochoanal polyp filling the left nasal cavity, without signs of expansion, or destruction and no obvious connection with intracranial tissue. Mass was removed endoscopically and histology confirmed glial nature of the mass. Conclusion: Any mass arising from sphenoid sinus should be carefully evaluated on CT scan for existence of fibrous stalk, or connection with brain tissue and needs to be considered in the differential diagnosis of the sphenochoanal mass. Complete surgical excision is the treatment of choice, which is curative.
基金This work was supported by Beijing Excellent Talents Foundation （No. 2010D003034000033）, Beijing Municipal Natural Science Foundation （No. 7112030）, and High Levels of Health Technical Personnel in Beijing City （No. 2011-3-047）.
文摘Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This study aimed to evaluate whether magnetic resonance imaging （MRI）,including dynamic contrast enhanced MRI （DCE-MRI）,could improve differentiation between IP and malignant tumors,and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.Methods Non-enhanced,static,and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results.MRI features of IP and malignant tumors including side,margin,T1 signal intensity,T1 homogeneity,T2 signal intensity,T2 homogeneity,lobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,pattern of enhancement,Tpeak,Tmax,Clmax,and TIC type were evaluated and correlated with histological findings.Results There were significant differences between IP and malignant tumors in T2 homogeneity,Iobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,Tpeak,Tmax and TIC types.A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity.Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity.Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern,extra-sinonasal involvement,and washout-type TIC for both observers （Wang XY and Zhang ZY）.Conclusion Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.
基金This work was supported by grants from Beijing Excellent Talents Foundation （No.2010D003034000033）,Beijing Municipal Natural Science Foundation （No.7112030）,High Levels of Health Technical Personnel in Beijing City （No.2011-3-047） and China Postdoctoral Science Foundation （No.2011M500026）.
文摘Background Quantitative dynamic contrast enhancement MR imaging （DCE-MRI）,used to measure properties of tissue microvasculature and tumor angiogenesis,is a promising method for distinguishing benign and malignant tumors and characterizing tumor response to antiangiogenic treatment.The aim of this study was to assess the feasibility of quantitative parameters derived from clinically used DCE-MRI for distinguishing benign from malignant tumors in the sinonasal area,which may be potentially useful for prediction and monitoring of treatment response to chemoradiotherapy of sinonasal tumors.Methods One hundred and forty-three patients with sinonasal tumors,including 78 malignant tumors and 65 benign tumors and tumor-like lesions,underwent clinically used DCE-MRI.Parametric maps were obtained for quantitative parameters including Ktrans,kep and ve.Two radiologists reviewed these maps and measured Ktrans,kep and ve in the tumor tissue.Data were analyzed using independent T-test or Mann-Whitney U test analysis and receiver operating characteristic curves.Results Ktrans,kep and ve showed significant differences between benign and malignant tumors in the sinonasal area （P=-0.000 1）.The accuracy of Ktrans,kep and ve in differentiation between benign and malignant sinonasal tumors were 72.0％,76.2％ and 67.1％,respectively.There were significant differences in kep and ve between malignant epithelial sinonasal tumors and lymphomas （P ＜0.05）.Using a ve value of 0.213 as the threshold value differentiated malignant epithelial tumors from lymphomas with an accuracy of 78.3％,sensitivity of 88.2％,specificity of 68.0％,positive predictive value of 66.7％,and negative predictive value of 90.9％.However,no significant difference in Ktrans and kep was found between malignant epithelial and non-epithelial tumors in the sinonasal area （P ＞0.05）.Conclusions It is feasible that quantitative parameters of tumors can be derived from clinically used DCE-MRI in the sinonasal region.Preliminary findings suggest an increased value for quantitative DCE-MRI in the evaluation of sinonasal tumors in clinical practice.
文摘Objective:We present the largest population based study of sinonasal squamous cell carcinoma(SCC)to identify risk factors for presentation with nodal metastasis.Methods:The National Cancer Database(NCDB)was used for this study.Location codes corresponding to the nasal cavity and paranasal sinuses and histology codes representing SCC malignancy were queried.Logistic regression analysis was performed to identify factors associated with presentation with nodal metastasis.Results:6448 cases met inclusion criteria.Nodal metastasis at presentation was seen in 13.2%of patients,with the sinus subsite(19.3%)being a significant risk factor for nodal metastasis at presentation when compared to the nasal cavity(7.9%).Logistic regression analysis showed black,uninsured and Medicaid patients were more likely than white and privately insured patients,respectively,to present with nodal metastasis.Conclusions:In sinonasal SCC,the sinus subsite has a significantly increased risk of nodal metastasis compared to the nasal cavity.Black race,uninsured and Medicaid patients are more likely to have nodal metastasis at presentation.
