Dyshormonogenetic goiter of the thyroid gland.

Endocrine, Thyroid
Thompson LD.
Ear Nose Throat J. 2005 Apr;84(4):200.
FIRST PARAGRAPH: Dyshormonogenetic goiter is the name given to a family of inborn errors of metabolism that lead to defects in the synthesis of thyroid hormone. The prevalence of this disease is 1 in 30,000 to 50,000 live births, and it is the second most common cause (10 to 15%) of permanent congenital hypothyroidism.
PubMed ID: 15929313
Article Size: <1 MB

Canalicular adenoma.

Head & Neck, Salivary Gland
Penner CR, Thompson L.
Ear Nose Throat J. 2005 Mar;84(3):132.
FIRST PARAGRAPH: Canalicular adenomas are benign neoplasms with a unique predilection for the upper lip (~80% of cases). They account for 1% of all salivary gland neoplasms. Their incidence peaks during the seventh decade of life; they are distinctly uncommon in patients younger than 50 years of age. The female-to-male predominance is approximately 2:1.
PubMed ID: 15871577
Article Size: <1 MB

Ossifying fibroma of the jaw.

Head & Neck, Oral Cavity/Gnathic (Jaw)
Gannon FH, Thompson L.
Ear Nose Throat J. 2004 Jul;83(7):458.
FIRST PARAGRAPH: Ossifying fibroma of the jaw is a benign, fibro-osseous lesion that is part of a larger family of fibro-osseous lesions that includes juvenile active ossifying fibroma, psammomatous ossifying fibroma, and extragnathic ossifying fibroma of the skull. Ossifying fibromas of the jaw are well-circumscribed, slowly growing lesions. They are often mentioned in the same differential diagnosis as fibrous dysplasia, but it is important to make the distinction because the former lends itself to ready enucleation, while the latter can be admixed with surrounding tissues, making surgery more complicated.
PubMed ID: 15372914
Article Size: <1 MB

Embryonal rhabdomyosarcoma of the ear.

Ear & Temporal Bone, Head & Neck
Sautter NB, Thompson LD.
Ear Nose Throat J. 2004 May;83(5):316-7.
FIRST PARAGRAPH: Rhabdomyosarcoma is the most common soft-tissue malignancy in the pediatric population. It is generally classified into embryonal, alveolar, pleomorphic, and mixed histologic subtypes. Embryonal rhabdomyosarcoma is the most common histologic variant seen in childhood; a large proportion of them arise in the head and neck—most commonly in the orbit, the nasopharynx, and the ear.
PubMed ID: 15195874
Article Size: <1 MB

Nasal glial heterotopia: a clinicopathologic and immunophenotypic analysis of 10 cases with a review of the literature.

Head & Neck, Sinonasal Tract
Penner CR, Thompson L.
Ann Diagn Pathol. 2003 Dec;7(6):354-9.
Nasal glial heterotopia (also known as ‘nasal glioma’), is a rare developmental abnormality seen in a wide age group but typically presenting at birth or in early childhood. Failure to recognize the entity is the principle difficulty in diagnosis. Ten cases of nasal glial heterotopic diagnosed between 1970 and 2000 were identified. Histologic and immunohistochemical features were evaluated and patient follow-up was obtained. The patients included five females and five males with a mean age at presentation of 8.6 years (range, birth to 44 years). Most patients presented clinically with a polypoid mass in the nasal cavity, although two patients had a mass on the nasal bridge. Symptoms were present for an average of 2 to 3 months. A connection to the central nervous system was identified in one case. Masses ranged in size from 1 to 7 cm in greatest dimension (mean, 2.4 cm). Histologically, the masses were composed of astrocytes (including gemistocytic type) and neuroglial fibers intermixed with a fibrovascular connective tissue stroma. Neurons and ependymal cells were noted in two cases. Focal calcifications and inflammatory cells were identified occasionally. Masson trichrome stains the collagen intensely blue, while the neural population stains magenta. Immunohistochemical reactivity with glial fibrillary acidic protein and S-100 protein will help to confirm the histologic diagnosis, while collagen type IV and laminin can highlight the reactive fibrosis. All cases were managed by surgery. All patients were alive without complications at last follow-up (mean, 26.8 years), except for the single fetus included in the study. Nasal glial heterotopia typically involves the nasal cavity and usually presents perinatally, although three patients presented in adulthood. The subtle glial component on routine microscopy can be accentuated with a trichrome stain or by immunoreactivity with glial fibrillary acidic protein and S-100 protein. Imaging studies must be performed before surgery to exclude an encephalocele, which requires different surgery. Complete surgical excision of nasal glial heterotopias is curative.
PubMed ID: 15018118
Article Size: <1 MB
 

Synovial sarcoma.

Head & Neck, Neck
Folk GS, Thompson LD.
Ear Nose Throat J. 2006 Jul;85(7):418-9.
FIRST PARAGRAPH: Synovial sarcoma (SS) is a unique tumor that usually involves the large joints. Approximately 10% of these tumors develop in the neck, oropharynx, hypopharynx, and larynx. Despite the name, these tumors neither originate from synovium nor express synovial differentiation. SS typically presents in young adults (median age: 25 yr). The male-to-female ratio is 3:1. Symptoms are site-specific but tend to be nonspecific. SS typically appears as a solitary, painless mass, occasionally accompanied by dyspnea or hoarseness. The diameter of the lesion ranges from 1 to 12 cm. The cut surface is yellow, firm, whorled, gritty, and friable; cyst formation with hemorrhage or mucoid material is often seen.
PubMed ID: 16909806
Article Size: <1 MB

Melanotic neuroectodermal tumor of infancy.

Head & Neck, Oral Cavity/Gnathic (Jaw)
Nelson BL, Thompson LD.
Ear Nose Throat J. 2006 Jun;85(6):365.
FIRST PARAGRAPH: Melanotic neuroectodermal tumor of infancy is a rare, neural-crest-derived neoplasm that is believed to be congenital. The tumor has a marked predilection for the head and neck — particularly the maxilla, where approximately 70% of these tumors are located. The anterior maxilla is most commonly affected. There is no predilection for either sex. Nearly all patients present with an enlarging mass, usually within a few years of birth. Intraoral lesions may appear ‘blue,’ suggesting the presence of pigment. Radiographic images will often show a destructive lesion with tooth displacement, but they are nonspecific. Laboratory studies show high urinary levels of vanillylmandelic acid.
PubMed ID: 16866106
Article Size: <1 MB

Epithelial-myoepithelial carcinoma.

Head & Neck, Salivary Gland
Folk GS, Thompson LD.
Ear Nose Throat J. 2006 Apr;85(4):214, 216.
FIRST PARAGRAPH: Epithelial-myoepithelial carcinoma (EMC) is an uncommon salivary gland malignancy, representing 1% of all salivary gland tumors. Women are more frequently affected (2:1). The incidence of EMC peaks between the ages of 50 and 60 years, although the age range is broad. The parotid gland is most frequently affected (60%), but both major and minor salivary glands can be involved. Patients typically present with a painless, slowly growing mass; occasionally there is rapid growth, pain, or facial weakness.
PubMed ID: 16696350
Article Size: <1 MB

Pituitary adenoma.

Endocrine, Pituitary
Thompson LD.
Ear Nose Throat J. 2006 Mar;85(3):152-3.
FIRST PARAGRAPH: Pituitary tumors account for approximately 15% of all intracranial neoplasms. They can be either benign or malignant, primary or secondary, and epithelial or nonepithelial. Pituitary carcinoma can only be diagnosed when there is confirmed metastatic disease. The vast majority are primary epithelial pituitary adenomas, which generally arise from hormone-producing cells, regardless of whether a particular tumor is active or inactive (i.e., non-hormone-producing). Pituitary adenomas are further classified on the basis of size, function, cell type, hormone production, location, and biologic behavior. Most pituitary adenomas are benign neoplasms, either null-cell or prolactin-producing microadenomas (<1 cm in their greatest dimension -- usually seen radiographically) that are seen within the pituitary gland. Most pituitary adenomas occur in women; they can arise at any age, but they are more common in the third through sixth decades of life. Patients with a pituitary adenoma present with either an endocrinopathy or a mass effect. Nonfunctioning adenomas exhibit no biochemical or clinical evidence of excessive hormone production. Patients with functional tumors present with specific syndromes, such as Cushing’s syndrome (adrenocorticotropic hormone-producing).
PubMed ID: 16615592
Article Size: <1 MB

Seborrheic keratosis.

Other Anatomic Sites, Skin
Thompson LD.
Ear Nose Throat J. 2006 Feb;85(2):79.
FIRST PARAGRAPH: Seborrheic keratosis is a benign proliferation of the epidermis. Many names are applied to this lesion (senile wart, melanoacanthoma), but seborrheic keratosis is the most widely accepted. Considered one of the most common skin lesions, it usually occurs in older patients; there is no predilection for either sex. The lesions appear “stuck on” the skin, usually on sun-exposed skin. They can be tan, brown, or black. Frequent irritation or friction may cause a papule/nodule to become red and scaly and result in a clinical misdiagnosis. Many variants of seborrheic keratosis are recognized clinically and histologically, but they have no management implications.
PubMed ID: 16579189
Article Size: <1 MB

Mucoepidermoid carcinoma.

Head & Neck, Salivary Gland
Thompson LD.
Ear Nose Throat J. 2005 Dec;84(12):762-3.
FIRST PARAGRAPH: Mucoepidermoid carcinoma (MEC) is the most common primary salivary gland malignancy, accounting for approximately 25% of all malignancies. More than half of these cases involve the major salivary glands, primarily the parotid glands. MEC can also involve a variety of other sites that have minor mucoserous glands. Women are more commonly affected than men (3:2), and the mean age at onset is in the 5th decade of life. MEC is also the most common salivary gland malignancy in children.
PubMed ID: 16408550
Article Size: <1 MB

Osteomyelitis.

Bone, Other Anatomic Sites
Gannon FH, Thompson LD.
Ear Nose Throat J. 2005 Nov;84(11):694.
FIRST PARAGRAPH: The proper treatment and clinical management of osteomyelitis (bone infection) depend on a successful correlation of its clinical features with radiologic and pathologic findings. Diagnostic difficulties may arise, and the final arbiter is intraoperative culture. The importance of intraoperative culture obtained in a ‘sterile’ environment cannot be overemphasized.
PubMed ID: 16381128
Article Size: <1 MB

Neuroendocrine adenoma of the middle ear.

Ear & Temporal Bone, Head & Neck
Thompson LD.
Ear Nose Throat J. 2005 Sep;84(9):560-1.
FIRST PARAGRAPH: Neuroendocrine adenomas of the middle ear, also known as middle ear adenomas and carcinoids, are rare neoplasms. These tumors occur equally in the genders, and they usually affect middle-aged patients. Patients present clinically with hearing loss and pain; tinnitus, equilibrium changes, and nerve paralysis might also be identified. Tumors are usually smaller than 1 cm in their greatest dimension, and they occasionally extend into the external or internal auditory canal.
PubMed ID: 16261754
Article Size: <1 MB

Metastatic cystic squamous cell carcinoma.

Head & Neck, Oropharynx
Thompson LD.
Ear Nose Throat J. 2005 May;84(5):272-3.
FIRST PARAGRAPH: Metastatic disease to the lymph nodes of the neck is an important clinical and pathologic consideration. When there is no known primary, the pathologist and radiologist must provide additional input to the clinician during the work-up. This installment of PATHOLOGY CLINIC focuses on cervical cystic squamous cell carcinoma (cSCC), which is commonly misdiagnosed as squamous cell carcinoma arising in a branchiogenic cyst or as a branchiogenic carcinoma.
PubMed ID: 15971745
Article Size: <1 MB

Diffuse sclerosing variant of papillary thyroid carcinoma: a clinicopathologic and immunophenotypic analysis of 22 cases.

Endocrine, Thyroid
Thompson LD, Wieneke JA, Heffess CS.
Endocr Pathol. 2005 Winter;16(4):331-48.
BACKGROUND: The diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) is an uncommon tumor making up about 2% of all papillary thyroid carcinomas. Previous studies have not comprehensively evaluated these tumors in a large series of patients.
DESIGN: Twenty-two cases of DSV-PTC diagnosed between 1970 and 2000 were identified in the files of the AFIP. Histologic and immunohistochemical features were evaluated and patient follow-up was obtained.
RESULTS: The tumors affected 14 females and 8 males, aged 6 to 49 yr (mean, 18 yr), with males presenting at a mean older age than females (24 vs 14 yr). Symptoms included an enlarging mass in the thyroid, present for a mean of 9.5 mo. While a dominant tumor was identified in a single lobe, bilateral disease was common (n = 16). The dominant mass ranged in size from 1.7 to 5.8 cm in diameter (mean, 3.8 cm). Histologically, all cases demonstrated a papillary carcinoma (conventional, solid, or follicular pattern) diffusely involving the gland. Extrathyroidal extension, lymphocytic thyroiditis, squamous metaplasia, increased fibrosis/sclerosis, and psammoma bodies were present to a variable degree. Both the papillary carcinoma and squamous metaplasia cells were strongly immunoreactive with CK19, thyroglobulin, and TTF-1. An increased number of S-100 protein immunoreactive dendritic cells were recognized. p53 was increased (>15%) in the tumor cells in 12 patients, while Ki-67 was increased in the tumor cells in two patients. Perithyroidal and cervical lymph node metastasis occurred in 18 (82%) patients. All metastases demonstrated histologic features similar to the primary. Complete resection (thyroidectomy in 18 patients) with lymph node dissection, yielded a 95% 5-yr survival without evidence of disease. One patient died of disease after a malignant transformation of the squamous metaplasia into squamous cell carcinoma.
CONCLUSIONS: The recognition of DSV-PTC can be made with the following features: classic to solid foci of PTC, lymphocytic thyroiditis, squamous metaplasia, increased fibrosis, and innumerable psammoma bodies. DSV-PTC is more biologically aggressive than conventional PTC, but the patients’ survival is not significantly different. This diagnosis should lead the clinician to aggressively manage these patients (thyroidectomy and lymph node dissection) in an effort to achieve an excellent long-term clinical outcome.
PubMed ID: 16627920
Article Size: <1 MB
 

Sinonasal tract glomangiopericytoma (hemangiopericytoma).

Head & Neck, Sinonasal Tract
Thompson LD.
Ear Nose Throat J. 2004 Dec;83(12):807.
FIRST PARAGRAPH: A glomangiopericytoma (sinonasal-type hemangio-pericytoma) is a tumor believed to derive from perivascular modified smooth-muscle cells. Its origin is similar to that of a glomus tumor (not to be confused with glomus jugulare, which is a different neoplasm) but distinctly different from soft-tissue hemangiopericytoma. There is a very slight female preponderance, and the tumor’s peak incidence occurs during the seventh decade of life. Most affected patients experience nasal obstruction and epistaxis along with a wide array of other nonspecific findings that are generally present for less than 1 year. Glomangiopericytomas have a predilection for the nasal cavity and paranasal sinuses, where they grow as polypoid masses. Their average size is approximately 3 cm, and they are often mistaken clinically for inflammatory polyps.
PubMed ID: 15724732
Article Size: <1 MB

Branchial cleft cyst.

Head & Neck, Neck
Thompson LD.
Ear Nose Throat J. 2004 Nov;83(11):740.
FIRST PARAGRAPH: A developmental alteration of the branchial clefts or pouches can result in cysts, sinuses, and/or fistulas. A branchial cleft cyst is a congenital abnormality usually located in the lateral neck along the anterior portion of the sternocleidomastoid muscle; it can also involve the ear and parotid salivary gland. There is no sex preference, and although the lesion usually presents clinically in young patients, older patients are occasionally affected as well. The cysts are typically nontender masses that may become secondarily inflamed or infected, which often brings them to clinical attention. Bilateral masses are associated with an increased likelihood of a syndrome.
PubMed ID: 15628626
Article Size: <1 MB

Papillary thyroid carcinoma.

Endocrine, Thyroid
Nelson BL, Thompson LD.
Ear Nose Throat J. 2004 Oct;83(10):675-6.
FIRST PARAGRAPH: Papillary thyroid carcinoma is the most common type of thyroid malignancy. The tumor occurs largely in adults, usually those between the ages of 20 and 50 years; the female-to-male ratio is 4:1. Papillary thyroid carcinoma is also the most common pediatric thyroid malignancy.
PubMed ID: 15586863
Article Size: <1 MB

Chondrosarcoma of the larynx.

Head & Neck, Larynx
Thompson LD.
Ear Nose Throat J. 2004 Sep;83(9):609.
FIRST PARAGRAPH: Chondrosarcoma of the larynx accounts for approximately 0.2% of all head and neck malignancies and approximately 1% of all laryngeal malignant tumors, although it is the most common nonepithelial neoplasm of the larynx. Men are affected more frequently than women (3:1 ratio), usually during the middle to later decades of life. Patients present with a variety of symptoms as a result of tumor growth, including dyspnea, dysphagia, hoarseness, airway obstruction, and/or pain.
PubMed ID: 15529643
Article Size: <1 MB

Management of melanotic neuroectodermal tumor of infancy.

Head & Neck, Oral Cavity/Gnathic (Jaw)
Gaiger de Oliveira M, Thompson LD, Chaves AC, Rados PV, da Silva Lauxen I, Filho MS.
Ann Diagn Pathol. 2004 Aug;8(4):207-12.
Melanotic neuroectodermal tumor of infancy is a rare congenital neoplasm involving the head and neck in young patients. The clinical assessment, histologic diagnosis, and management is reviewed, with an emphasis on different treatment alternatives in two new case reports.
PubMed ID: 15290671
Article Size: <1 MB
 

Skin keloid.

Other Anatomic Sites, Skin
Thompson LD.
Ear Nose Throat J. 2004 Aug;83(8):519.
FIRST PARAGRAPH: A keloid is a form of excessive scar formation that occurs in response to tissue injury. Keloids arise as a result of abnormal wound healing where there is a disruption of the balance between collagen formation and degradation with a shift toward excess synthesis. Even with injuries that are seemingly minor, the resultant scar formation is disproportionately excessive. The etiology is unknown.
PubMed ID: 15487627
Article Size: <1 MB

HIV-associated Hodgkin lymphoma: a clinicopathologic and immunophenotypic study of 45 cases.

Head & Neck, Neck
Thompson LD, Fisher SI, Chu WS, Nelson A, Abbondanzo SL.
Am J Clin Pathol. 2004 May;121(5):727-38.
We retrospectively analyzed 45 cases of HIV-associated Hodgkin lymphoma (HIV-HL). HIV-HL generally is a disease of young white men (mean age, 40.1 years) who acquired HIV infection by homosexual or bisexual behavior (68%), intravenous drug use (24%), and/or blood transfusion (8%). The mean interval between the diagnosis of HIV and HIV-HL was 5.2 years. Morphologic classification of nodal biopsy specimens (2001 World Health Organization criteria) included 15 mixed cellularity Hodgkin lymphomas (MCHLs), 14 nodular sclerosis Hodgkin lymphomas (NSHLs), 9 lymphocyte depleted Hodgkin lymphomas (LDHLs), and 7 classic Hodgkin lymphomas, type not further categorized. The Hodgkin-Reed-Sternberg (HRS) cells expressed positive immunoreactivity with fascin (30/30 [100%]), CD30 (35/37 [95%]), CD15 (32/36 [89%]), bcl-X(L) (25/31 [81%]), bcl-2 (15/29 [52%]), CD20 (4/34 [12%]), bcl-6 (3/28 [11%]), and Epstein-Barr virus latent membrane protein-1 (32/33 [97%]) and were nonreactive for CD138/syndecan-1. CD4 and CD8 immunostaining showed an inverted CD4/CD8 ratio (<1/20) in all cases. At diagnosis, most patients (n = 27) had high-stage disease (IV(E)) associated with an aggressive course (16% 5-year survival). LDHL behaved more aggressively than MCHL and NSHL (15% vs 40%, 5-year survival, respectively), as did disease with a sarcomatoid pattern (11% 5-year survival). Chemotherapy and radiotherapy proved efficacious in a minority of these patients.
PubMed ID: 15151213
Article Size: <1 MB
 

Endoscopic management of intratracheal ectopic thyroid.

Endocrine, Thyroid
Pritchyk KM, Thompson LD, Malekzadeh S.
Otolaryngol Head Neck Surg. 2004 May;130(5):630-2.
CASE REPORT CONCLUSIONS: ITET is a rare cause of upper airway obstruction. CT scan of the neck without contrast should be performed to evaluate the location of obstruction. MRI scan should be used to assess the extent and vascular nature of the lesion. Endoscopic laser excision is an appropriate treatment option for benign and vascular ITET tissue.
PubMed ID: 15138431
Article Size: <1 MB
 

Kimura disease: a clinicopathologic study of 21 cases.

Head & Neck, Neck
Chen H, Thompson LD, Aguilera NS, Abbondanzo SL.
Am J Surg Pathol. 2004 Apr;28(4):505-13.
Kimura disease is a rare form of chronic inflammatory disorder involving subcutaneous tissue, predominantly in the head and neck region and frequently associated with regional lymphadenopathy and/or salivary gland involvement. This condition has a predilection for males of Asian descent and may clinically simulate a neoplasm. Kimura disease is sometimes confused with angiolymphoid hyperplasia with eosinophilia, which occurs in the superficial skin of the head and neck region. Although sporadic cases have been reported in non-Asians, there is no large, comprehensive study of Kimura disease in the United States. We report 21 cases with nodal involvement that, histologically, are consistent with Kimura disease. There were 18 males and 3 females (male/female ratio 6:1), 8 to 64 years of age (mean, 32 years), and included 7 Caucasians, 6 Blacks, 6 Asians, 1 Hispanic, and 1 Arabic. Anatomic sites of involvement included posterior auricular (n = 10), cervical (n = 6), inguinal (n = 3), and epitrochlear (n = 2) lymph nodes, with two patients having associated salivary gland involvement. Most (n = 16) cases had peripheral blood eosinophilia. Consistent histologic features were follicular hyperplasia, eosinophilic infiltrates, and proliferation of postcapillary venules. Follow-up data on 18 patients revealed that 13 were alive without disease (3 had recurrence), mean follow-up, 10.9 years; 4 were alive with disease (2 had a recurrence), mean follow-up, 8.8 years; and 1 died with disease (12.7 years). Kimura disease has been described more often in Asians, but it does occur in non-Asians with a similar clinicopathologic presentation. It is a distinctive entity with no known etiology. Kimura disease has characteristic histologic features that are important to recognize and can be used to differentiate it from hypersensitivity and drug reactions and infections.
PubMed ID: 15087670
Article Size: 4 MB
 

Ceruminous adenomas: a clinicopathologic study of 41 cases with a review of the literature.

Ear & Temporal Bone, Head & Neck
Thompson LD, Nelson BL, Barnes EL.
Am J Surg Pathol. 2004 Mar;28(3):308-18.
BACKGROUND: Ceruminous gland neoplasms are rare neoplasms. To date, a large clinicopathologic study of benign ceruminous gland neoplasms has not been reported.
DESIGN: Forty-one cases of ceruminous gland adenomas diagnosed between 1970 and 2000 were retrieved from the files of the Armed Forces Institute of Pathology. Histologic features were reviewed, immunohistochemical analysis was performed (n = 21), and patient follow-up was obtained (n = 40).
RESULTS: The patients included 22 men and 19 women, 24 to 85 years of age (mean, 54.2 years). Patients presented clinically with a painless mass of the outer half of the external auditory canal (n = 33) or with hearing changes (n = 11). Symptoms were present for an average of 16.3 months. The polypoid masses affected the external auditory canal only and ranged in size from 0.4 to 2 cm in greatest dimension (mean, 1.1 cm). Histologically, the tumors demonstrated glands and small cysts lined by a tubuloglandular proliferation of inner ceruminous cells (cerumen-secreting epithelium with decapitation secretion) subtended by a spindled to cuboidal myoepithelial layer. A hyalinized stroma created an infiltrative pattern of growth; surface involvement (n = 8) was seen. Tumors were divided into ceruminous adenoma (n = 36), ceruminous pleomorphic adenoma (n = 4), and syringocystadenoma papilliferum (n = 1) types. The luminal cells were strongly and diffusely immunoreactive with CK7, while the basal cells were highlighted with CK5/6, S-100 protein, and p63. CD117 highlighted the luminal cells preferentially. The proliferation markers revealed a low index. Adenocarcinoma and middle ear adenoma are the principal differential consideration. Surgical excision was used in all patients. Four patients developed a recurrence due to incomplete excision. All patients were without evidence of disease at the last follow-up: alive (n = 28, mean 16.3 years) or dead (n = 12, mean 11.8 years).
CONCLUSION: Ceruminous gland adenomas are the most common external auditory canal tumors. They demonstrate a dual cell population of basal myoepithelial-type cells and luminal ceruminous (ceruminal) cells. Cerumen pigment, CK7, and p63 can help to distinguish this tumor from other neoplasms that occur in the region. Complete surgical excision results in an excellent long-term clinical outcome.
PubMed ID: 15104293
Article Size: 2 MB
 

Nasal glial heterotopia.

Head & Neck, Sinonasal Tract
Penner CR, Thompson LD.
Ear Nose Throat J. 2004 Feb;83(2):92-3.
FIRST PARAGRAPH: Nasal glial heterotopia (nasal glioma) is the term used to describe a mass made up of mature brain tissue that is isolated from the cranial cavity or spinal canal. Most of these rare, benign, congenital tumors are found in the nasal region, particularly at the bridge of the nose and in the nasal cavity. Nasal glial heterotopia is frequently diagnosed in newborns; a few cases have been found in adults.
PubMed ID: 15008441
Article Size: <1 MB

Oral cicatricial pemphigoid.

Head & Neck, Oral Cavity/Gnathic (Jaw)
Nelson BL, Thompson LD.
Ear Nose Throat J. 2004 Jan;83(1):22.
FIRST PARAGRAPH: Cicatricial pemphigoid is a vesiculobullous disease of the skin that may be found in the oral cavity. Previously designated ‘benign mucous membrane pemphigoid,’ cicatricial pemphigoid is a chronic, blistering, autoimmune disease that affects mucous membranes. Tissue-bound autoantibodies are directed against one or more components of the basement membrane in an affected individual. Cicatricial pemphigoid initially occurs in the fifth to seventh decades of life, and it is observed more frequently in women. Patients usually describe oral pain and/or ulceration, often of many years’ duration. Clinically, the disease is characterized by the formation of bullae, which can be found anywhere in the oral cavity. The bullae rupture and produce ulceration, which may cause a scar (cicatrix) upon healing.
PubMed ID: 14986753
Article Size: <1 MB

Papillary cystadenoma lymphomatosum (Warthin tumor).

Head & Neck, Salivary Gland
Rizzi MD, Thompson LD.
Ear Nose Throat J. 2003 Dec;82(12):920-2.
FIRST PARAGRAPH: Papillary cystadenoma lymphomatosum (Warthin tumor, adenolymphoma) is a benign salivary gland tumor that occurs almost exclusively in the parotid gland. It represents 5 to 6% of all salivary gland tumors, and it is the second most common benign parotid neoplasm. Men are affected more often than women, usually in the fifth to seventh decades of life, although this gender proportion is changing. Warthin tumor is associated with smoking. The most common clinical manifestation is a painless, slowly growing mass in the inferior pole of the superficial lobe of the parotid gland, usually at the level of the mandibular angle. Multifocality occurs in up to 14% of cases; when two salivary gland neoplasms are present synchronously, Warthin tumor is the most common second tumor.
PubMed ID: 14702874
Article Size: <1 MB

Larynx amyloidosis.

Head & Neck, Larynx
Akst LM, Thompson LD.
Ear Nose Throat J. 2003 Nov;82(11):844-5.
FIRST PARAGRAPH: Amyloidosis is a benign accumulation of extracellular, insoluble, fibrillar protein. In general, the deposition of amyloid may be either localized or systemic and either primary or secondary. Laryngeal amyloidosis is rare, accounting for less than 1% of all benign laryngeal tumors. When it does occur, it is commonly localized and primary. Multifocal disease is present in up to 15% of patients. The disease typically manifests as hoarseness or vocal changes in the fifth to sixth decades, and it affects men and women equally.
PubMed ID: 14661432
Article Size: <1 MB

Kimura disease.

Head & Neck, Neck
Chen H, Thompson LD.
Ear Nose Throat J. 2003 Oct;82(10):763.
FIRST PARAGRAPH: Kimura disease is a rare, chronic inflammatory disorder that involves subcutaneous tissues, predominantly those in the head and neck region. Its etiology is unknown, but it is frequently associated with regional lymphade-nopathy and/or salivary gland involvement. Kimura disease has a predilection for males of Asian descent. Clinically, it can simulate a neoplasm, and most patients have peripheral blood eosinophilia and elevated serum immunoglobulin E (IgE) levels.
PubMed ID: 14606173
Article Size: <1 MB

Malignant transformation of a dysembryoplastic neuroepithelial tumor after radiation and chemotherapy.

Neuro (brain), Other Anatomic Sites
Rushing EJ, Thompson LD, Mena H.
Ann Diagn Pathol. 2003 Aug;7(4):240-4.
We describe a case of anaplastic astrocytoma in a 14-year-old boy arising at the site of a dysembryoplastic neuroepithelial tumor (DNT) 3 years after combined radiation and chemotherapy. The subtotally excised superficial right temporoparietal tumor was originally diagnosed as mixed oligoastrocytoma in 1974; the patient was treated with radiation therapy postoperatively. One year later he underwent a craniotomy to remove cyst fluid and no change was reported in the size of the residual tumor. Postoperatively, he received a 6-week course of chemotherapy (lovustine, CCNU). He remained clinically and radiographically stable until 3 years later, when seizure activity returned and imaging studies were consistent with tumor recurrence. He was lost to follow-up until 1986, when records showed that he had died. Review of the initial biopsy showed cortical fragments containing abundant calcifications and multinodular structures typical of the complex form of DNT, in addition to specific glioneuronal elements. The Ki-67 labeling index ranged from 0.1% to 3% focally. The specimen from the third surgery showed an anaplastic astrocytoma (Ki-67 up to 12%) and morphologic features characteristic of radiation effect. This is the first documented case of malignant transformation of DNT following radiation and adjuvant chemotherapy. The implications of malignant transformation in subtotally excised complex DNTs and the intriguing issue of the contribution of radiation/chemotherapy are discussed.
PubMed ID: 12913847
Article Size: <1 MB
 

Molluscum contagiosum.

Other Anatomic Sites, Skin
Nelson BL, Thompson LD.
Ear Nose Throat J. 2003 Aug;82(8):560.
FIRST PARAGRAPH: Molluscum contagiosum is a virus-induced epithelial hyperplasia produced by a DNA poxvirus. This common disease can be found on the skin and mucosal surfaces. It is acquired by direct contact with an infected individual or, less commonly, by contact with a fomite (e.g., clothing, towels, and toys); autoinoculation is common. Molluscum contagiosum is usually seen in children and young adults; immunocompromised persons are especially vulnerable to infection. Lesions predominantly arise on the skin of the face, neck, eyelids, trunk, and genitalia, as well as on the mucous membranes of these areas (as applicable). The incubation period averages between 2 and 7 weeks, although it can be much longer.
PubMed ID: 14503090
Article Size: <1 MB

Adrenal cortical neoplasms in the pediatric population: a clinicopathologic and immunophenotypic analysis of 83 patients.

Adrenal, Endocrine
Wieneke JA, Thompson LD, Heffess CS.
Am J Surg Pathol. 2003 Jul;27(7):867-81.
Adrenal cortical neoplasms in pediatric patients (<20 years) are rare. The clinical manifestations and biologic behavior of these lesions can be quite distinct from their histologically similar counterparts in the adult population, making pathologic criteria for distinguishing benign from malignant tumors equivocal. We undertook a study of 83 adrenal cortical neoplasms to determine if adult clinical and histologic features can be applied to pediatric patients in an outcome-based analysis. Most of the patients (50 girls and 33 boys) presented with hormone-related symptoms present for a mean of 6.8 months. The tumors ranged in size from 2 to 20 cm (mean 8.8 cm). Histologic parameters examined included capsular and/or vascular invasion, extraadrenal soft tissue extension, growth pattern, cellularity, necrosis, cytoplasmic eosinophilia, nuclear pleomorphism, nuclear-to-cytoplasmic ratio, prominent nucleoli, mitotic figures, atypical mitotic figures, bands of fibrosis, and calcifications. Immunophenotypically, there was reactivity with inhibin, vimentin, CK5, and focally with p53 and Ki-67. All patients underwent adrenalectomy, and 20 patients received adjuvant therapy. All patients with tumors classified as adenomas (n = 9) were alive, without evidence of disease (mean 14.7 years), whereas 21 patients with carcinomas had died with disease (mean 2.4 years). Only 31% of histologically malignant tumors behaved in a clinically malignant fashion. Features associated with an increased probability of a malignant clinical behavior included tumor weight (>400 g), tumor size (>10.5 cm), vena cava invasion, capsular and/or vascular invasion, extension into periadrenal soft tissue, confluent necrosis, severe nuclear atypia, >15 mitotic figures/20 high power fields, and the presence of atypical mitotic figures. Vena cava invasion, necrosis, and increased mitotic activity (>15 mitotic figures/20 high power fields) independently suggest malignant clinical behavior in multivariate analysis.
PubMed ID: 12826878
Article Size: 2 MB
 

Intratracheal ectopic thyroid tissue: a case report and literature review.

Endocrine, Thyroid
Byrd MC, Thompson LD, Wieneke JA.
Ear Nose Throat J. 2003 Jul;82(7):514-8.
We discuss a case of intratracheal ectopic thyroid tissue (ETT) that was retrieved from the files of the Otorhinolaryngic–Head and Neck Pathology Registry at the Armed Forces Institute of Pathology. The patient was a 54-year-old man who had a history of papillary thyroid carcinoma, which had been treated with a subtotal thyroidectomy. During routine follow-up 4 years later, the patient’s primary care physician detected an elevated thyroglobulin level. Further referrals and evaluations revealed that the patient had intratracheal ETT. The patient refused to undergo surgical excision and remains without evidence of recurrent carcinoma. In a MEDLINE literature review, we found only 13 other well-documented cases of intratracheal ETT since 1966; in all but two cases, patients had benign disease. Once the possibility of thyroid carcinoma has been eliminated by histologic examination, intratracheal ETT can be managed by complete surgical excision with the prospect of an excellent long-term clinical outcome.
PubMed ID: 12955837
Article Size: <1 MB

Necrotizing sialometaplasia.

Head & Neck, Oral Cavity/Gnathic (Jaw)
Penner CR, Thompson LD.
Ear Nose Throat J. 2003 Jul;82(7):493-4.
FIRST PARAGRAPH: Necrotizing sialometaplasia is a benign, self-limited, reactive inflammatory process that involves salivary glands. It occurs in middle-aged patients; men are affected slightly more often than women. Patients may experience an antecedent event (e.g., surgery, radiation, or trauma) up to 3 weeks before necrotizing sialometaplasia appears clinically, but many are asymptomatic. A submucosal nodular swelling will give way to an ulcerative, crater-like lesion that usually measures less than 3 cm in its greatest dimension.
PubMed ID: 12955830
Article Size: <1 MB

Sinonasal-type hemangiopericytoma: a clinicopathologic and immunophenotypic analysis of 104 cases showing perivascular myoid differentiation.

Head & Neck, Sinonasal Tract
Thompson LD, Miettinen M, Wenig BM.
Am J Surg Pathol. 2003 Jun;27(6):737-49.
Sinonasal-type hemangiopericytoma is an uncommon upper aerodigestive tract tumor of uncertain cellular differentiation. We report 104 cases of sinonasal-type hemangiopericytoma diagnosed between 1970 and 1995 from the files of the Armed Forces Institute of Pathology. There were 57 females and 47 males ranging in age from 5 to 86 years (mean 62.6 years). The most common clinical presentation was airway obstruction (n = 57) and/or epistaxis (n = 54), with symptoms averaging 10 months in duration. The tumors involved the nasal cavity alone (n = 47) or also a paranasal sinus (n = 26), were polypoid, and measured an average of 3.1 cm. Histologically, the tumors were submucosal and unencapsulated and showed a diffuse growth with fascicular (n = 37) to solid (n = 50) to focally whorled (n = 7) patterns. The tumor cells were uniform in appearance with minimal pleomorphism and had spindle-shaped (n = 82) to round/oval (n = 18) nuclei with vesicular to hyperchromatic chromatin and eosinophilic to amphophilic to clear-appearing cytoplasm with indistinct cell borders. Multinucleated (tumor) giant cells were identified in a minority of cases (n = 5). Mitotic figures were inconspicuous and necrosis was absent. The tumors were richly vascularized, including staghorn-appearing vessels that characteristically had prominent perivascular hyalinization (n = 92). An associated inflammatory cell infiltrate that included mast cells and eosinophils was noted in the majority of cases (n = 87). The immunohistochemical profile included reactivity with vimentin (98%), smooth muscle actin (92%), muscle specific actin (77%), factor XIIIa (78%), and laminin (52%). Surgery was the treatment of choice for all of the patients; adjunctive radiotherapy was given to four patients. Recurrences developed in 18 patients within 1-12 years from diagnosis. Ninety-seven patients were either alive (n = 51, mean 16.5 years) or dead (n = 46, mean 9.6 years) but free of disease. Four patients had disease at the last follow-up: three died with disease (mean 3.6 years) and one patient is alive with disease (28.3 years). Recurrent tumor (17.8%) can be managed by additional surgery. The majority of sinonasal-type hemangiopericytomas behave in a benign manner with excellent long-term prognosis (88% raw 5-year survival) following surgery alone. Sinonasal-type hemangiopericytomas have a characteristic light microscopic appearance with an immunophenotypic profile resembling that of glomus tumors.
PubMed ID: 12766577
Article Size: 2 MB
 
 
 
 

Polymorphous hemangioendothelioma of the neck.

Head & Neck, Neck
Tadros M, Rizk SS, Opher E, Thompson LD.
Ann Diagn Pathol. 2003 Jun;7(3):165-8.
Polymorphous hemangioendotheliomas are rare, low-grade borderline malignant vascular tumors of endothelial cell origin. To the best of our knowledge (MEDLINE 1966-2002), there have been nine cases of polymorphous hemangioendothelioma reported in the English literature. Most of the initial patients reported were men, but we present the third case in a woman. Her previous radiation history to the neck makes this report unique. Polymorphous hemangioendothelioma is characterized by the variety of patterns of growth within and between tumors, making histologic recognition of the tumor difficult. Because management remains conservative via wide local excision, the misdiagnosis of this lesion as a malignancy has possible treatment implications. Alternatively, the high propensity for local recurrence underscores the necessity for accurate classification of the neoplasm and close clinical follow-up.
PubMed ID: 12808568
Article Size: <1 MB
 

Tracheopathia osteoplastica.

Head & Neck, Larynx
Penner CR, Thompson LD.
Ear Nose Throat J. 2003 Jun;82(6):427.
FIRST PARAGRAPH: Tracheopathia osteoplastica (tracheobronchopathia osteochondroplastica) is a segmental degenerative disorder of the tracheobronchial tree. It is characterized by multiple submucosal cartilaginous and osseous nodules of various sizes that cause a narrowing of the upper respiratory tract. This disorder is most common in elderly men, and it is occasionally associated with chronic inflammation or with trauma. Tracheopathia osteoplastica can manifest clinically as nonspecific signs and symptoms, although stridor and dyspnea are common. Radiologic studies may suggest the diagnosis if scalloped nodular calcified opacities are seen in the submucosa. The diagnosis is confirmed after endoscopic and pathologic examination.
PubMed ID: 12861866
Article Size: <1 MB

Sinonasal tract and nasopharyngeal melanomas: a clinicopathologic study of 115 cases with a proposed staging system.

Head & Neck, Sinonasal Tract
Thompson LD, Wieneke JA, Miettinen M.
Am J Surg Pathol. 2003 May;27(5):594-611.
Primary sinonasal tract mucosal malignant melanomas are uncommon tumors that are frequently misclassified, resulting in inappropriate clinical management. A total of 115 cases of sinonasal tract mucosal malignant melanoma included 59 females and 56 males, 13-93 years of age (mean 64.3 years). Patients presented most frequently with epistaxis (n = 52), mass (n = 42), and/or nasal obstruction (n = 34) present for a mean of 8.2 months. The majority of tumors involved the nasal cavity (n = 34), septum alone, or a combination of the nasal cavity and sinuses (n = 39) with a mean size of 2.4 cm. Histologically, the tumors were composed of a variety of cell types (epithelioid, spindled, undifferentiated), frequently arranged in a peritheliomatous distribution (n = 39). Immunohistochemical studies confirmed the diagnosis of sinonasal tract mucosal malignant melanomas with positive reactions for S-100 protein, tyrosinase, HMB-45, melan A, and microphthalmia transcription factor. Sinonasal tract mucosal malignant melanomas need to be considered in the differential diagnosis of most sinonasal malignancies, particularly carcinoma, lymphoma, sarcoma, and olfactory neuroblastoma. Surgery accompanied by radiation and/or chemotherapy was generally used. The majority of patients developed a recurrence (n = 79), with 75 patients dying with disseminated disease (mean 2.3 years), whereas 40 patients are either alive or had died of unrelated causes (mean 13.9 years). A TNM-type classification separated by anatomic site of involvement and metastatic disease is proposed to predict biologic behavior.
PubMed ID: 12717245
Article Size: 2 MB
 

Primary parathyroid hyperplasia.

Endocrine, Parathyroid
Penner CR, Thompson LD.
Ear Nose Throat J. 2003 May;82(5):363.
FIRST PARAGRAPH: Parathyroid hyperplasia is classified as either primary, secondary, or tertiary. Primary parathyroid hyperplasia occurs in approximately 15% of patients with hyperparathyroidism. Most cases are sporadic, and they usually occur in patients who are middle-aged and older. Approximately 20% of all cases of primary chief-cell hyperplasia are associated with one of the multiple endocrine neoplasia syndromes. Symptoms are referable to the level and duration of serum calcium elevation, although routine biochemical testing has led to an increase in the identification of asymptomatic patients. Biochemically, ionized serum calcium levels are elevated, and serum phosphorus concentrations are lowered. Technetium-99m sestamibi imaging successfully localizes as many as 60% of hyperplastic glands, although this technique is significantly more effective in localizing adenomas and carcinomas. Therefore, at least two glands should be examined histologically to confirm the diagnosis.
PubMed ID: 12789760
Article Size: <1 MB

Mesenchymal chondrosarcoma of the sinonasal tract: a clinicopathological study of 13 cases with a review of the literature.

Head & Neck, Sinonasal Tract
Knott PD, Gannon FH, Thompson LD.
Laryngoscope. 2003 May;113(5):783-90.
OBJECTIVES/HYPOTHESIS: Mesenchymal chondrosarcoma of the sinonasal tract is a rare, malignant tumor of extraskeletal origin. Isolated cases have been reported in the English literature, with no large series evaluating the clinicopathological aspects of these tumors.
STUDY DESIGN: Retrospective review. METHODS: Thirteen patients with sinonasal mesenchymal chondrosarcoma were retrieved from the Otorhinolaryngologic-Head and Neck Registry of the Armed Forces Institute of Pathology.
RESULTS: Nine women and 4 men (age range, 11 to 83 y; mean age, 38.8 y) presented with nasal obstruction (n = 8), epistaxis (n = 7), or mass effect (n = 4), or a combination of these. No patients reported prior head and neck irradiation. The maxillary sinus was the most common site of involvement (n = 9), followed by the ethmoid sinuses (n = 7) and the nasal cavity (n = 5). Tumors had an overall mean size of 5.1 cm. Microscopically, the tumors displayed a small, blue, round cell morphology appearance arranged in a hemangiopericytoma-like pattern with foci of cartilaginous matrix. All cases were managed by surgery with adjuvant radiation therapy (n = 4) and/or chemotherapy (n = 3). The overall mean survival was 12.1 years, although five of six patients who developed local recurrences died of disease (mean survival, 6.5 y). Six patients were alive and disease free (mean survival, 17.3 y), and two patients were lost to follow-up.
CONCLUSIONS: Mesenchymal chondrosarcoma of the sinonasal tract is an aggressive tumor with a predilection for young women. The pattern of growth and scarcity of cartilaginous matrix result in frequent misdiagnosis. Recurrence develops in approximately one-third of patients and seems to predict a poor prognosis. Aggressive, exenterative surgery combined with adjuvant therapy appears to yield the best clinical outcome.
PubMed ID: 12792311
Article Size: 2 MB
 

Malignant giant cell tumor of the sphenoid.

Head & Neck, Sinonasal Tract
Chan J, Gannon FH, Thompson LD.
Ann Diagn Pathol. 2003 Apr;7(2):100-5.
Malignant giant cell tumors (MGCTs) of the sphenoid sinus are extremely rare neoplasms. They are challenging to diagnose and difficult to treat because of their skull base location. To the best of our knowledge, we report the first case of a primary MGCT of the sphenoid arising in a patient with Paget’s disease. A 77-year-old man presented with epistaxis and a history of Paget’s disease. There was normal cranial nerve function although radiographic images disclosed a large mass centered in the sphenoid sinus and extending into the ethmoid and maxillary sinuses. Excisional biopsy revealed a MGCT composed of a cellular stroma with increased mitotic activity and necrosis with giant cells present throughout. Additional therapy was declined and the patient died with disease 7 months later. Because of their rarity, no treatment guidelines exist for the management of MGCTs of the sphenoid. We discuss both the diagnostic and therapeutic considerations based on a review of the pertinent literature.
PubMed ID: 12715335
Article Size: <1 MB
 

Fibrous dysplasia of bone.

Head & Neck, Oral Cavity/Gnathic (Jaw)
Nelson BL, Thompson LD.
Ear Nose Throat J. 2003 Apr;82(4):259.
FIRST PARAGRAPH: Fibrous dysplasia (fibro-osseous metaplasia) is one of a diverse group of diseases that are characterized by alterations in bone growth. It is a developmental, tumor-like process of unknown etiology. Its initial clinical sign is usually a painless enlargement of the affected bone. It occurs in equal proportions in males and females, most often during the first two decades of life.
PubMed ID: 12735156
Article Size: <1 MB

Tonsil with Tangier disease.

Head & Neck, Oropharynx
Nelson BL, Thompson LD.
Ear Nose Throat J. 2003 Mar;82(3):178.
FIRST PARAGRAPH: Tangier disease is a rare autosomal-recessive inherited disorder that is caused by a defect in chromosome 9q31. It is characterized by a severe deficiency or absence of high-density lipoproteins in plasma. A defect in cellular cholesterol removal results in the massive, abnormal accumulation of cholesterol esters in macrophages in many tissues. Although this accumulation is most conspicuous in the tonsils, progressive accretion of these esters also occurs in nerves (neuropathy) and vessels (atherosclerosis). The pathognomonic finding is a low plasma cholesterol concentration accompanied by normal or elevated triglyceride levels and large, lobulated, hyperplastic, bright orange-yellow tonsils and adenoid tissue. Affected families have been identified on Tangier Island, Va., in Chesapeake Bay as well as in Missouri, Kentucky, and Europe.
PubMed ID: 12696235
Article Size: <1 MB

Primary ear and temporal bone meningiomas: a clinicopathologic study of 36 cases with a review of the literature.

Ear & Temporal Bone, Head & Neck
Thompson LD, Bouffard JP, Sandberg GD, Mena H.
Mod Pathol. 2003 Mar;16(3):236-45.
‘Primary’ ear and temporal bone meningiomas are tumors that are frequently misdiagnosed and unrecognized, resulting in inappropriate clinical management. To date, a large clinicopathologic study of meningiomas in this anatomic site has not been reported. Thirty-six cases of ear and temporal bone meningiomas diagnosed between 1970 and 1996 were retrieved from our files. Histologic features were reviewed, immunohistochemical analysis was performed (n = 19), and patient follow-up was obtained (n = 35). The patients included 24 females and 12 males, aged 10-80 years (mean, 49.6 years), with female patients presenting at an older age (mean, 52.0 years) than male patients (mean, 44.8 years). Patients presented clinically with hearing changes (n = 20), otitis (n = 7), pain (n = 5), and/or dizziness/vertigo (n = 3). Symptoms were present for an average of 24.6 months. The tumors affected the middle ear (n = 25), external auditory canal (n = 4), or a combination of temporal bone and middle ear (n = 7). The tumors ranged in size from 0.5 to 4.5 cm in greatest dimension (mean, 1.2 cm). Radiographic studies demonstrated a central nervous system connection in 2 patients. Histologically, the tumors demonstrated features similar to those of intracranial meningiomas, including meningothelial (n = 33), psammomatous (n = 2), and atypical (n = 1). An associated cholesteatoma was identified in 9 cases. Immunohistochemical studies confirmed the diagnosis of meningioma with positive reactions for epithelial membrane antigen (79%) and vimentin (100%). The differential diagnosis includes paraganglioma, schwannoma, carcinoma, melanoma, and middle ear adenoma. Surgical excision was used in all patients. Ten patients developed a recurrence from 5 months to 2 years later. Five patients died with recurrent disease (mean, 3.5 years), and the remaining 30 patients were alive (n = 25, mean: 19.0 years) or had died (n = 5, mean: 9.5 years) of unrelated causes without evidence of disease. We conclude that extracranial ear and temporal bone meningiomas are rare tumors histologically similar to their intracranial counterparts. They behave as slow-growing neoplasms with a good overall prognosis (raw 5-y survival, 83%). Extent of surgical excision is probably the most important factor in determining outlook because recurrences develop in 28% of cases.
PubMed ID: 12640104
Article Size: 2 MB
 

Cystic chondromalacia of the ear.

Ear & Temporal Bone, Head & Neck
Nelson BL, Thompson LD.
Ear Nose Throat J. 2003 Feb;82(2):104-5.
FIRST PARAGRAPH: Idiopathic cystic chondromalacia (endochondral pseudocyst of the auricle) is a benign cystic degenerative lesion of the auricular cartilage. The lesion appears as a painless unilateral swelling along the upper half of the ear, usually in the area of the scaphoid or triangular fossae adjacent to the helix. The disorder affects young and middle-aged men more often than it does women. Trauma is an associated, although not proven, etiologic factor.
PubMed ID: 12619465
Article Size: <1 MB

Ameloblastoma.

Head & Neck, Oral Cavity/Gnathic (Jaw)
Thompson LD.
Ear Nose Throat J. 2003 Jan;82(1):19.
FIRST PARAGRAPH: Ameloblastomas are locally aggressive gnathic tumors that have a high propensity for recurrence. They are believed to arise from remnants of the odontogenic epithelium or the developing enamel organ. They occur in patients over a wide spectrum of ages and equally among the sexes, as a slow-growing, often asymptomatic, locally invasive tumor. Radiographic images usually demonstrate a multilocular, expansile radiolucency of bone, usually of the posterior mandible.
PubMed ID: 12610896
Article Size: <1 MB

Causes of death of patients with laryngeal cancer.

Head & Neck, Larynx
Ferlito A, Haigentz M Jr, Bradley PJ, Suárez C, Strojan P, Wolf GT, Olsen KD, Mendenhall WM, Mondin V, Rodrigo JP, Boedeker CC, Hamoir M, Hartl DM, Hunt JL, Devaney KO, Thompson LD, Rinaldo A, Takes RP.
Eur Arch Otorhinolaryngol. 2014 Mar;271(3):425-34.
Despite remarkable advances in the care of patients with laryngeal cancer over the past several decades, including a growing awareness of therapeutic complications and attention to quality of life, little is known about the causes of mortality in this population. In addition to the laryngeal malignancy itself, acute and late or chronic treatment-associated causes, second primary cancers, intercurrent disease and psychosocial factors are all responsible for patient morbidity and mortality. We examine the current literature related to the causes of death in patients with laryngeal cancer, in the hope of guiding future interventions to improve the longevity and quality of life of individuals with this cancer.
PubMed ID: 23591796
Article Size: <1 MB
 

Otic polyp.

Ear & Temporal Bone, Head & Neck
Thompson LD.
Ear Nose Throat J. 2012 Nov;91(11):474-5.
FIRST PARAGRAPHS: An uncommon entity, otic polyp arises in response to a long-standing inflammatory or infectious process of the middle ear, most often in young boys. An otic, or aural, polyp is a benign proliferation of chronic inflammatory cells and granulation tissue that is usually lined with benign reactive epithelium. These lesions arise in response to a long-standing inflammatory or infectious process of the middle ear. Otic polyps are uncommon; when they do occur, they usually affect young patients. They are more common in males than in females.
PubMed ID: 23288791
Article Size: <1 MB

Osteosarcoma.

Head & Neck, Oral Cavity/Gnathic (Jaw)
Thompson LD.
Ear Nose Throat J. 2013 Jul;92(7):288-90.
FIRST PARAGRAPHS: Osteosarcoma affects the mandible and the maxilla differently, with mandibular tumors tending to arise from the body of the mandible while maxillary tumors arise from the alveolar ridge and sinus. Osteosarcoma is a mesenchymal malignancy in which the neoplastic cells synthesize and secrete the organic components of bone matrix. While it is the most common primary tumor of bone, it is very uncommon overall.
PubMed ID: 23904301
Article Size: <1 MB