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Sinonasal myxoma: a pediatric case.J
Pediatr Hematol Oncol. 2005 Feb;27(2):90-2.
The authors
report a case of a rare facial myxoma arising from the maxillary sinus
in a 20-month-old child. The diagnosis was confirmed by a biopsy, and
the patient underwent a partial maxillectomy to achieve a total
resection of the mass due to the locally aggressive nature of the
lesion. Myxomas should be differentiated from malignant sarcomas, in
particular embryonal rhabdomyosarcoma, which can arise from the same
location and require multimodality therapy consisting of surgery,
irradiation, and chemotherapy.
Pediatric sinonasal rhabdomyosarcoma: three cases and a
review of the literature.Am
J Otolaryngol. 2003 May-Jun;24(3):174-80.
OBJECTIVE: To
understand the clinical presentation, management, and natural history
of paranasal rhabdomyosarcoma. DESIGN: Retrospective case series
review. METHODS: Retrospective medical record review of patients less
than 20 years of age who presented to our facility with
rhabdomyosarcoma of the nasal cavity or paranasal sinuses. RESULTS:
Medical records of all pediatric patients seen in our pediatric
otolaryngology clinic were reviewed from January 1, 1995, through
December 31, 2000. Three patients were identified with sinonasal
rhabdomyosarcoma. Their presentation, evaluation, and treatment were
evaluated. Relevant literature 1966 to the present was reviewed with
the assistance of Medline. CONCLUSIONS: Rhabdomyosarcoma is an
aggressive pediatric malignancy, requiring a high index of suspicion
to detect it in its earliest stages. Patients with suggestive symptoms
should undergo a full evaluation including nasal endoscopy and
imaging. Because the current chemotherapy protocols are more effective
on localized disease, early diagnosis is crucial to patient survival.
Midline nasal mass in infancy: a nasal glioma case report.Eur
J Pediatr Surg. 2001 Oct;11(5):324-7
Congenital
midline nasal masses are rare anomalies that occur in about one in
20,000-40,000 live births. The most common are dermoid/epidermoid
tumors, nasal cerebral heterotopias (nasal gliomas), and nasal
encephaloceles; some have an actual or potential central nervous
system connection. Nasal gliomas are CNS masses of neurogenic origin
which have lost their intracranial connections and present as an
obvious external or intranasal mass at birth without associated
surgical symptoms. Careful evaluation is required to confirm the
diagnosis and appropriate management. The interpretation of CT and MR
images can be difficult but is useful in differentiating nasal gliomas
from other congenital nasal masses. The presence of a fibrous stalk
may be associated with cranial defects and CSF leak. Excisional biopsy
allows histopathologic diagnosis and is the definitive treatment. They
are benign lesions, and recurrences are rare, so conservative cosmetic
surgical techniques should be chosen for gliomas where there is no
proven intracranial extension. The authors report an illustrative
nasal glioma case in a one-year-old male infant with extranasal and
intranasal components, and discuss the therapeutic options.
Lobular
capillary haemangioma of the nasal cavity: observation of three
specific cases.
Acta Otorhinolaryngol Belg.
2001;55(3):241-6.
Lobular
Capillary Haemangioma of the nasal cavity: Observation of three
specific cases. Lobular Capillary Haemangioma, unproperly called "Pyogenic
granuloma", is a benign vascular tumour pedunculated on the skin and
on mucous membranes of the oral and nasal cavities. Microtrauma and
pregnancy are the most often evocated aetiologic factors. Epistaxis
and nasal obstruction are the most marked symptoms of this irregular
and friable mass. We report three cases (two adult and one paediatric)
of this pathology. Two have as trigger factor a nasal microtrauma, the
third an oestro-progestative impregnation. A clinical, radiological
and histological description allows us to expose the characteristics
of this lesion that remains obscure to many rhinologists. Lobular
Capillary Haemangioma has to be evocated in the differential diagnosis
of each haemorrhagic endonasal mass.
Primary nasal-paranasal
oropharyngeal lymphoma in the pediatric age group.Cancer.
1990 Mar 15;65(6):1438-44
Nasal-paranasal
oropharyngeal (NPOP) non-Hodgkin's lymphoma (NHL) is a disease of the
very young (median age, 5 years) and of the aging adult (median age,
50-60 years). Of a total of 208 pediatric patients with NHL studied,
20 (9.6%) had primary NPOP. Sixty percent of the patients had Stage I
and II disease. Primary sites were maxillary sinus in eight patients;
tonsils in eight; posterior pharynx in two; mandible in one; and orbit
in one patient. Histologically, the disease is different than that of
the adults since most patients had B-cell lymphomas of the diffuse
undifferentiated type (Rappaport) or small cell non-cleaved types (Lukes-Collins,
Kiel, and Working Formulation). None of these patients had
gastrointestinal involvement. All patients were treated with the
LSA2-L2 regimen and radiation therapy was given to primary
unresectable tumors and regional metastases. The lymphoma event-free
survival was 75%, with a median observation period of 99+ months. In
staging systems that refer mostly to amount of disease outside of the
primary (such as ours, Murphy's, and the Ann Arbor staging systems)
stage did not correlate well with disease-free survival. In the TNM
staging of 1977, a staging system that refers to size of primary tumor
as well as regional and systemic disease, stage correlated better with
prognosis and survival. In our staging system, eight of 12 patients
(66.7%) with Stage I and II disease; four of four with Stage III; two
of two with Stage IVA; and zero of two with Stage IVB survived. In the
TNM staging system, three of three patients with Stage II and III
disease and 12 of 18 patients (67%) with Stage IV disease survived.
All recurrences occurred early suggesting that early intensification
of chemotherapy may produce better results.
Problems in pediatric otorhinolaryngic pathology. IV.
Epithelial and lymphoid tumors of the sinonasal tract and nasopharynx.Int
J Pediatr Otorhinolaryngol. 1983 Dec;6(3):219-37.
The clinical and
histopathologic diagnostic problems of childhood nasopharyngeal
carcinoma, sinonasal epithelial tumors, and Burkitt's lymphoma are
described, and the relationship of the Epstein-Barr virus to tumors is
discussed.
Problems in pediatric otorhinolaryngic pathology, III.
Teratoid and neural tumors of the nose, sinonasal tract, and
nasopharynx.Int
J Pediatr Otorhinolaryngol. 1983 Sep;6(1):1-21
The
terminology, classification, and histopathologic features of teratoid
and neural masses of the nasal area of children can be confusing.
Definitions, clinical features, and histopathologic differential
diagnoses are discussed.
Problems in
pediatric otorhinolaryngic pathology. II. Vascular tumors and lesions
of the sinonasal tract and nasopharynx.Int
J Pediatr Otorhinolaryngol. 1983 Apr;5(2):125-38.
Vascular
tumors and lesions of the nasal passages of children can be easily
misdiagnosed. The clinical and histopathologic features that aid
differential diagnosis are discussed.
Nasal mass in a
pediatric patient.Head
Neck. 1992 Sep-Oct;14(5):415-8
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