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5 results

  • The incidence of significant pathology in patients presenting with benign-appearing unilateral nasal polyps

  • O Edafe, G Weight, M Morsy, S Mirza
  • Journal:
    The Journal of Laryngology & Otology / Volume 136 / Issue 10 / October 2022
    Published online by Cambridge University Press:
    06 May 2022, pp. 998-1001
    Print publication:
    October 2022
  • Objective

    The presentation of unilateral nasal polyps traditionally necessitates histological evaluation for a neoplasm. This study sought to determine the rates of significant pathology in patients presenting with benign-appearing unilateral nasal polyps, to inform practice.

    Method

    All patients who underwent nasal polypectomy for benign-appearing unilateral nasal polyps over a 13-year period were included.

    Results

    A total of 77 patients were included. On histology, 60 cases (77.9 per cent) were found to be inflammatory polyps. Thirteen cases were neoplastic, of which 11 (14.3 per cent) were benign and 2 (2.6 per cent) were malignant neoplasms. The following significant pathologies were found: Schneiderian papillomas, in 10 cases (13.0 per cent); neurofibroma, in 1 case (1.3 per cent); adenoid cystic carcinoma, in 1 case (1.3 per cent); and malignant melanoma, in 1 case (1.3 per cent).

    Conclusion

    Our data support routine histological assessment for all unilateral nasal polyps. Malignancy is rare (2.6 per cent) in patients presenting with benign-appearing unilateral nasal polyps. In elderly, unfit patients with minimal symptoms, initial conservative management may be reasonable.

  • Sinonasal malignancy: presentation and outcomes

  • Y B Mahalingappa, H S Khalil
  • Journal:
    The Journal of Laryngology & Otology / Volume 128 / Issue 7 / July 2014
    Published online by Cambridge University Press:
    23 June 2014, pp. 654-657
    Print publication:
    July 2014
  • Objective:

    We wanted to identify the presentation, diagnostic work-up and treatment outcomes of patients with sinonasal malignancy at Derriford Hospital, Plymouth, UK and compare these with the European Position Paper on Endoscopic Management of Tumours of the Nose, Paranasal Sinuses and Skull Base.

    Materials and methods:

    This was a retrospective audit of all patients diagnosed with sinonasal malignancy over a five-year period. The clinical records and picture archiving and communications system data of the patients were reviewed.

    Results:

    Thirty patients with sinonasal malignancy were identified out of 570 head and neck cancer patients. The nasal cavity was the most common site for presentation, followed by the maxillary sinuses. Fifty per cent of patients had a squamous cell carcinoma and 27 per cent had a malignant melanoma. Half of the patients presented at stage IV of the cancer and 20 per cent at stage III. Thirty-seven per cent of patients underwent surgical management and only 20 per cent of the total patient group underwent endoscopic surgery. The mortality in our series was 30 per cent over the studied period.

    Conclusion:

    Late-stage presentation of sinonasal malignancy has resulted in increased patient mortality in our case series. Also, we found a high incidence of malignant melanoma with high recurrence and survival rates.

  • Extraskeletal Ewing’s sarcoma of the nose

  • Andrej Böör, Ivan Jurkovič, Imrich Friedmann, Lukás Plank, Pavol Kočan
  • Journal:
    The Journal of Laryngology & Otology / Volume 115 / Issue 1 / January 2001
    Published online by Cambridge University Press:
    08 March 2006, pp. 74-76
    Print publication:
    January 2001

  • A 20-year-old woman presented with nasal obstruction and slight epistaxis. The obstructing lesion was excised and microscopy showed a neoplasm composed of comparatively uniform undifferentiated cells forming solid nests. The cytoplasm of the cells was clear but poorly demarcated, partly vacuolated and contained much glycogen. Although widespread in the nasal mucosa, the cells did not penetrate into the underlying bone.

    The cells expressed the MIC2 gene (using the CD99 marker). Electron microscopy showed simple cells with a small number of mitochondria, many glycogen particles; there were no neurosecretory granules present.

    Early surgical treatment followed by chemo- and radiotherapy have greatly improved the prognosis of EWS: extraskeletal Ewing’s sarcoma (EWS/PNET).

  • Acute leukaemic cell infiltration of the nose

  • A. S. Bais, K. Uppal, K. B. Logani, S. Narayan
  • Journal:
    The Journal of Laryngology & Otology / Volume 106 / Issue 3 / March 1992
    Published online by Cambridge University Press:
    29 June 2007, pp. 261-263
    Print publication:
    March 1992

  • Leukaemic cell infiltration of the nose as a first manifestation of the disease is extremely rare. We report a case of a three year-old child who had presented with a swelling at the root of the nose for one month and proptosis of the right eye for one week. CT scan revealed a mass infiltrating the nose and nasal cavity along with infiltration of the retro-orbital region. Biopsy showed it to be myeloid cell deposits. Patient was put on antileukaemic chemotherapy but died two months after the first appearance of the symptoms.