Unilateral Mass Research Articles

Giant Epidermoid Cyst of the Maxillary Sinus: A Postoperative Complication?

Epidermoid cysts are benign lesions, which are usually detected on the floor of the mouth in the head and neck region. They can develop from abnormal epithelial components of an ectoderm tissue during the embryological life or alternatively they can arise from the implanted epithelium after trauma or surgery. The diagnosis of an epidermoid cyst in the maxillary sinus can be challenging and it could be easily mistaken for any benign or malign lesion of the nasal cavity and paranasal sinuses. In this case, we present a 44-year-old man with a giant epidermoid cyst in the right maxillary sinus with a previous history of paranasal sinus surgery. We present a very rare case of epidermoid cyst and also discuss the importance of radiological imaging modalities in differential diagnosis of a unilateral expansile mass in the maxillary sinus.

A Bilateral Metachronous Mesothelioma of the Tunica Vaginalis

This is a unique case of bilateral metachronous testicular mesothelioma of the tunica vaginalis. Testicular mesothelioma is a rare entity found in patients with or without asbestos occupational exposure. The tumor most commonly presents as a unilateral testicular mass. More rare presentations include bilateral synchronous or metachronous tumors. Treatment is with surgical resection and prognosis is not generally favorable. The benefits of adjuvant therapy with radiation or chemotherapy remain unknown and further studies are needed.

Chondro-osseous Respiratory Epithelial Adenomatoid Hamartoma (COREAH) : A rare entity of nasal mass

Chondro-osseous respiratory epithelial adenomatoid hamartoma (COREAH) is an extremely rare benign lesion of the nose and paranasal sinuses. Clinically the lesion presents as a polypoid mass and histologically can be easily confused with more threatening tumors such as inverted papilloma and sinonasal carcinoma. A correct and accurate diagnosis is really important as all of these lesions are treated by different surgical approach. Here we report a case of COREAH in a middle-age lady who presented with unilateral nasal mass with chronic nasal obstruction.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.489-492

Adrenal incidentaloma: differential diagnosis and management strategies.

Adrenal incidentaloma is a frequent clinical finding. Once an adrenal mass is detected, is mandatory to determine whether the lesion is malignant or benign and whether it is hormonally active or non-functioning, to estabilish an adequate treatement or follow-up. The European Society of Endocrinology and ENSAT Guideline recently provided the best recommendation based on the available literature. However, due to the retrospective design of the majority of the studies, the small number of patients included and the inadequate follow-up, some issues are still unresolved. In particular, there is a general consensus about the need of adrenalectomy in the presence of unilateral adrenal mass and clinically relevant hormone excess or radiological findings suspected for malignancy. On the other side, how to manage adrenal masses with indeterminate characteristics or subtle cortisol secretion, and how long the radiological and functional follow-up of benign adrenal mass should last in non-operated patients, are still open questions. Therefore, high-quality research for establish the adequate management of these patients and randomized clinical trials are needed to avoid unnecessary investigations and invasive procedures and ensure a clinically effective work-up.

Primary adrenal diffuse large B cell lymphoma: a clinicopathological and molecular study from China.

Primary adrenal lymphoma is a rare entity that, in most cases, is derived from B cells. The most commonly seen primary adrenal lymphoma is diffuse large B cell lymphoma (DLBCL). To better understand the clinicopathological and molecular features of these tumors, we studied 14 Chinese patients with DLBCL who initially presented with an adrenal tumor. The clinicopathological features of the 14 primary adrenal DLBCL cases were retrospectively reviewed using immunohistochemistry, immunoglobulin gene rearrangement analysis, evaluation of Epstein-Barr virus status, and fluorescence in situ hybridization. Patient age ranged from 43 to 69years, with a mean age of 58years. The patients most commonly presented with abdominal pain and adrenal mass. Ten patients exhibited bilateral adrenal masses, and four had unilateral adrenal masses (three left, one right). Thirteen of 14 DLBCLs were DLBCL not otherwise specified, and one was an intravascular large B cell lymphoma. According to the algorithm of Hans et al. (Blood 103:275-282, 2004), 13 and 1 cases were classified as the non-germinal center B-cell-like subtype and the germinal center B-cell-like subtype, respectively. The Ki-67 index ranged from 35 to 80%. Epstein-Barr virus-encoded RNA was detected by in situ hybridization in 6 of the 12 available cases. Two patients showed BCL-6 rearrangements. The follow-up period ranged from 1 to 87months. During the follow-up period, four patients died of the disease, five were alive with the disease, four were alive without disease, and one was lost during the follow-up period. In summary, most primary adrenal lymphomas are non-germinal-center B-cell-like subtype DLBCLs, which have high proliferative activity and a poor prognosis.

LIKELY BACTERIAL ACUTE CERVICAL LYMPHADENITIS IN CHILDREN: FACTORS PREDICTIVE OF FAVORABLE OUTCOME

Abstract BACKGROUND Cervical lymphadenitis is frequent in the paediatric population and usually the result of infectious agents. Management of likely bacterial acute cervical lymphadenitis (LBACL) mainly relies on expert advice and may vary widely from antibiotherapy to surgery as no official guidelines have been published over the last decade. OBJECTIVES To identify factors associated with favorable outcome in the management of LBACL in children in order to create a decision algorithm and its further evaluation. DESIGN/METHODS This retrospective observational study was based on the review of medical records of patient from 1 month to 18 years old who have consulted for LBACL between July 2010 and July 2015 at a tertiary care paediatric center. LBACL were identified using electronic record databases (hospitalization, emergency). Patients were included if they had acute (≤10 days) episode of unilateral cervical mass of which the final diagnosis was LBACL. Exclusion criteria were: mycobacterial adenitis, Kawasaki disease, Cat-scratch disease, bilateral cervical lymph node involvement, congenital malformation, immunodeficiency or underlying neoplasia. Favorable evolution was defined as outpatient treatment or hospital stay of 48 hours or less without surgical drainage. To identify factors at initial consultation predictive of a favorable outcome, we performed univariate logistic regression models with several potential independent covariates, including, among others, age (years), size of lymph node (mm), fever (38,5°C), an antibiotic use prior to consultation, fluctuation, absolute white blood cell count (x10^9/L), and purulent material at ultrasonography (yes/no). RESULTS Our final study cohort was composed of 166 patients with a mean age of 4,5 years (3,5SD) and 62% male. Ultrasound was obtained in 139(83,7%) patients and cervical tomodensitometry in 31(18,7%). Surgical drainage was performed in 35(21,1%). Overall, 68(41,0%) patients presented a favorable evolution from which 27(16,9%) were treated as outpatient (figure1). Factors associated with favorable outcome were (OR; 95%CI): age (1.17; 1.06–1.29; p=0.002), absolute white blood cell count (0.91; 0.87–0.96; p=0.001), no antibiotic use prior to consultation (0.26; 0.07–0.92; p=0.037) and absence of purulent material on ultrasound (0.07; 0.02–0.29; p<0.001). Size of lymph node (0.98; 0.96–1.00; p=0,057) or fluctuation (0.71; 0.21–2.39; p=0.57) did not achieved statistical significance. CONCLUSION Older patients without prior antibiotic use, those with lower absolute white blood cell count and no purulent material on ultrasound seem to better evolve than other children with likely bacterial acute cervical lymphadenitis. A decision algorithm to identify patients eligible for conservative management should include those predictive factors.

Childhood Nasopharyngeal Carcinoma (NPC): A Review of Clinical-Imaging Features and Recent Trends in Management

Introduction: Nasopharyngeal carcinoma (NPC) in children and adolescents is a relatively rare yet highly malignant disease. Clinical presentation of NPC in this age group is non-specific and varied leading to a predominantly late diagnosis. The objective of this paper is to explore and clarify the tumour’s ambiguity and assess the precision of imaging in mapping its morphology and loco-regional extension and possible distant metastases. Treatment regimes that minimize adverse radio-therapeutic effects on surrounding structures will be highlighted. Method: Retrospective analysis and observations of literature (in English) between 2004 to December 2017 was performed. A search was performed using the Medline data-base. The following are the search terms: “children”, “nasopharyngeal carcinoma”, “symptoms’, “imaging” and “therapy”. Material: Of the 43 papers found on the primary search only 36 satisfied the search criteria. Four review papers of the primary search were retained as sources of reference. The core material comprised 22 papers on NPC’s clinical presentation and the role of imaging in diagnosis and prognostication. There were three papers on advanced imaging in adults. The rest of the seven comprised selected articles on chemo-radiation, radiotherapy and related late toxicities. Results: The clinical presentations range from nasal stuffiness, otalgia to unilateral or bilateral neck masses. Symptoms can last from a few weeks to 6 months; by then disease can be advanced. A WHO high-grade undifferentiated squamous cell carcinoma is the commonest lesion in clinical practice. Data from magnetic resonance imaging (MRI) focusing on tumour extensions and tumour volume are markers of long-term prognosis. Diffusion weighted MRI by assessing microscopic changes of NPC can determine the ultimate outlook of adults afflicted with NPC. Treatment of paediatric NPC consists of induction chemotherapy followed by radiotherapy with dosage up to 65-70 Gy. Morphologically, the main mimicker of childhood NPC is an embryonic parameningeal rhabdomyosarcoma arising from the pharyngeal and nasal space. Both have inclination to invade the skull base. Conclusion: Despite NPC’s varied and nonspecific presentations, the clinician must be vigilant because treatment of the disease in different stages of severity has a higher response rate than its adult counterpart. Contrast MRI and computed tomography (CT) are precise in showing skull base invasion, loco-regional and distant metastases. The application of diffusion weighted MRI has a role in determining the tumour’s microscopic contents and long-term prognosis. Use of intensity modulated radiation therapy (IMRT) in addition to induction chemotherapy and irradiation treatment regime has decreased the incidence of the dreaded late sequelae.

A case report of Rosai Dorfman disease

<p>Rosai-Dorfman’s disease also known as sinus histiocytosis with massive lymphadenopathy (SHML) is characterized by distorted lymph node architecture with marked dilation of lymphatic sinuses occupied by numerous lymphocytes, as well as histiocytes with vesicular nucleus and abundant clear cytoplasm with phagocytized lymphocytes or plasma cells, also known as ‘emperipolesis’. This disease of unknown etiology progresses with a benign prognosis strictly and only when an early diagnosis and treatment is made. A late diagnosis and a generalized lymph node involvement contribute to a poor prognosis. We reported a case of a 29-year-old Indian female with a 4-month history of painful unilateral cervical mass and low-grade fever with the final diagnosis of Rosai-Dorfman disease. The final diagnosis was made by fine needle aspiration (FNA) biopsy of the cervical lymph node. In conclusion, FNA biopsy can be enough to make the diagnosis in most cases due to the distinct cytological features of SHML, thereby avoiding more invasive approaches that potentially are unnecessary.</p>

Fibrosarcoma arising in the paranasal sinus: a clinicopathological and radiological analysis.

To analyze the clinicopathological features and the CT and MRI features of patients with paranasal sinus fibrosarcoma. Seven patients with surgically and pathologically confirmed paranasal sinus fibrosarcoma were enrolled. Their CT and MRI data and imaging features were retrospectively analyzed in detail. The study participants were two males and five females (median age, 43 years; range, 22-73 years). CT or MRI showed a well-defined (n = 5) or ill-defined (n = 2), irregular (n = 6) or oval (n = 1) mass, with heterogeneous (n = 7) density. The lesions were isointense (n = 4) or hypointense (n = 2) on T1weighted images, and showed heterogeneous (n = 6) mild hypointensity on T2weighted images. Expansive (n = 6) and osteolytic (n = 1) bone destruction were observed. The tumors showed marked heterogeneous delayed enhancement (n = 6) on contrast-enhanced MRI images. Paranasal sinus fibrosarcomas should be included in the differential diagnosis when a sinonasal neoplasm appears as a well- or ill-defined unilateral large irregular mass with characteristic mild hypointensity on T2weighted MR images and shows expansive or osteolytic bone destruction and a marked heterogeneous delayed contrast-enhancement pattern.

Adrenal schwannoma: CT, MR manifestations and pathological correlation.

This study aimed to describe the computed tomography (CT), magnetic resonance imaging (MRI) imaging features of adrenal schwannoma and to correlate imaging findings with histopathologic findings. The findings from multiphase CT or MRI examinations of seventeen patients with histopathologically confirmed adrenal schwannoma were reviewed. The imaging criteria included shape, size, margin, attenuation, signal intensity, secondary degeneration, and internal mass enhancement pattern. All cases were unilateral, round or oval solitary tumors, with diameters ranging from approximately 2.5 to 8.8 cm (median = 4.5 cm). Of the twelve cases assessed using CT, adrenal schwannoma appeared as well-circumscribed round or oval low-density suprarenal masses with a mean attenuation values of 30.1 HU of solid portions during unenhanced phase. Ten cases exhibited heterogeneous cyst formation, and one case showed calcification. Internal septa were noted in 5 cases. All solid areas displayed early mild heterogeneous enhancement and delayed progressive enhancement. Regarding MRI, solid portions of five masses were hypointense to the liver parenchyma on T1-weighted imaging (T1WI) and were heterogeneously hyperintense on T2-weighted imaging (T2WI). The enhanced pattern of solid areas of adrenal schwannoma on MRI is similar to that of CT. Cystic or hemorrhagic changes were noted in 4 cases and internal septa were noted in 3 cases. Although schwannoma is a rare entity in the adrenal gland, we believe that the following signs may suggest the diagnosis of this entity: a non-lipid containing mass, a well-defined border, a unilateral mass with cystic or hemorrhagic degeneration, septa with delayed enhancement and a characteristic progressive contrast enhancement pattern of the solid portions.

PD51-07 OUTCOMES OF SYNCHRONOUS AND METACHRONOUS BILATERAL SMALL RENAL MASSES (

You have accessJournal of UrologyKidney Cancer: Localized: Active Surveillance1 Apr 2018PD51-07 OUTCOMES OF SYNCHRONOUS AND METACHRONOUS BILATERAL SMALL RENAL MASSES (<4CM): A POPULATION BASED COHORT STUDY Nissar Sheikh, Mohammad Khan, stephen Lang, Sanjay Pillai, and Ghulam Nabi Nissar SheikhNissar Sheikh More articles by this author , Mohammad KhanMohammad Khan More articles by this author , stephen Langstephen Lang More articles by this author , Sanjay PillaiSanjay Pillai More articles by this author , and Ghulam NabiGhulam Nabi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2347AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report longitudinal outcomes of a population based cohort of patients diagnosed with bilateral small renal masses from a period of over 11 years. METHODS Consecutive patients diagnosed with bilateral small renal masses (synchronous or metachronous) of a defined geographical area were recorded in a large database (TUCAN database) between January 2005 and December 2016. Patients had a unique identifier number and followed during this period using an agreed upon protocol. Clinicopathological characteristics and outcomes of bilateral small renal masses on active surveillance were analysed and compared to propensity score matched sporadic unilateral small renal masses. Data were analysed for renal mass growth rate, rate of intervention and development of metastatic disease and patient survival. RESULTS A total of 1600 patients were diagnosed with renal cancer, of which bilateral small renal masses accounted for 70 (6.6%) cases. Synchronous SRMs were observed in 63 patients, whereas metachronous lesions were found in seven patients during the study period. Metachronous lesion mean time to appearance was 62 ± 41 months (range, 9 to 149 months). While most cases were sporadic, four were found to be hereditary. Growth rate of bilateral small renal masses did not differ from that of unilateral sporadic small renal masses. Similarly, there were no between group differences for rate of interventions and survival. CONCLUSIONS Progression, rate of metastases and survival for patients diagnosed with bilateral small renal masses is similar to those diagnosed with unilateral disease. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e978 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nissar Sheikh More articles by this author Mohammad Khan More articles by this author stephen Lang More articles by this author Sanjay Pillai More articles by this author Ghulam Nabi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Endoscopic Removal of a Rare Case of Extranasopharyngeal Angiofibroma: A Case Report and Review Article

Introduction: Angiofibroma is a benign, un-encapsulated, and highly vascular tumor which typically arises from the pterygopalatine fossa in the young adolescent males. It predominantly extends into the nasopharynx and rarely develops extranasopharyngeally. However, the most common origins of extranasopharyngeal angiofibromas are the maxillary sinus, ethmoid sinus and nasal cavity. Case Presentation: Here, we report a 40-year-old male who presented with headache and epistaxis and was diagnosed as an extranasopharyngeal angiofibroma originated from the sphenoid sinus. The tumor was completely resected endoscopically. The 24-month follow-up showed no recurrence. Conclusions: Angiofibromas should be considered as a possible diagnosis in any unilateral vascular mass of the nasal cavity, even in the older patients without typical imaging patterns.

Outcomes of synchronous and metachronous bilateral small renal masses (

To report longitudinal outcomes of a population-based cohort of patients diagnosed with bilateral small renal masses from a period of over 11years. Consecutive patients diagnosed with bilateral small renal masses (synchronous or metachronous) of a defined geographical area were recorded in a large database (TUCAN database) between January 2005 and December 2016. Patients had a unique identifier number and followed during this period using an agreed upon protocol. Clinicopathological characteristics and outcomes of bilateral small renal masses on active surveillance were analysed and compared to propensity score-matched sporadic unilateral small renal masses. Data were analysed for renal mass growth rate, rate of intervention and development of metastatic disease and patient survival. A total of 1060 patients were diagnosed with renal cancer, of which bilateral small renal masses accounted for 70 (6.6%) cases. Synchronous SRMs were observed in 63 patients, whereas metachronous lesions were found in seven patients during the study period. Metachronous lesion mean time to appearance was 62±41months (range 9-149months). While most cases were sporadic, four were found to be hereditary. Growth rate of bilateral small renal masses did not differ from that of unilateral sporadic small renal masses. Similarly, there were no differences between the groups for rate of interventions and survival. Progression, rate of metastases and survival for patients diagnosed with bilateral small renal masses are similar to those diagnosed with unilateral disease.

Diagnosis and Treatment of 75 Patients with Idiopathic Lobular Granulomatous Mastitis

ABSTRACTIdiopathic granulomatous lobular matitis (IGLM) is a rare non-specific inflammatory disease of the breast. Although IGLM is completely benign, it is easily confused with cancer due to progressive breast lump with firmly unilateral and discrete mass, nipple retraction and sinus formation. Patients with IGLM are usually associated with inflammation of the overlying skin. This study aimed to investigate the clinical characteristics of IGLM, treatment options and prognosis. From January 2010 to February 2015, 75 IGLM patients in our hospital were included, with an average age of 35.9 ± 10.0 (range 21–61) years. Most of them were parous. The main clinical characteristic was the presence of a large, irregular and painful mass. Hypoechoic lobulated, irregular tubular or oval shaped masses were detected by breast gland ultrasound. Ill-defined mass, enlarged axillary lymph nodes, asymmetric density, and architectural distortion were found by breast molybdenum palladium X-ray. Diagnosis of IGLM was confirmed with histological examination. The majority (60/75) of the IGLM patients received surgical treatment, including lumpectomy, abscess drainage or mastectomy. Antibiotics were used after surgery. The disease recurred in three patients during the follow-up period. Our study suggested that IGLM diagnosis more depends on CNB and postoperative histopathological examination, and surgery and symptomatic treatment can completely remove the lesions, in order to cure the disease.

Clinical and pathological findings of enzootic nasal adenocarcinoma of goat

The enzootic nasal tumor (ENT), a contagious tumor, is raised from the secretory epithelial cells of the ethmoid turbinate in animal which is caused by ENT virus type (ENTV) 2. The aim of this study is to investigate the clinical, radiological, and histopathological features of ENT or nasal adenocarcinoma in Lori-Bakhtiari breeds of goat. The affected goats showed respiratory nasal problems, continuous nasal exudate, and death resulted from progressive respiratory distress and anorexia. Dorsomedial radiographs of the skull region showed the mass in the right caudal paranasal sinus region deformation of bone in the near ethmoidal part. At necropsy, after dissection of the cranium through sagittal dorsomedial section, the presences of large unilateral tumor sessile masses with white, shiny, and soft like a gelatin form appearances were found. Acinar and papillary patterns were the most common histopathological finding in proliferated glands. The neoplastic cells were cuboidal or columnar with round or oval nuclei with very low mitotic index. This type of carcinoma originates from the serous gland cells in ethmoidal turbinate.

MRI appearance of ovarian serous borderline tumors of the micropapillary type compared to that of typical ovarian serous borderline tumors: radiologic-pathologic correlation

BackgroundSerous borderline tumor (SBT) of the micropapillary type (SBT-MP) became one of the major pathological SBT diagnoses in addition to typical SBT, and was also defined as “non-invasive” low-gradeserous carcinoma according to the World Health Organization (WHO) classification in 2014. In this study, we investigated the MRI appearance of SBT-MP compared to that of typical SBT in order to identify specific imaging features of SBT-MP that correspond to pathological findings.MethodsMR images of 6 histologically proven ovarian SBT-MP in four patients and 14 typical SBT in ten patients were reviewed retrospectively. Images were evaluated for laterality, size and morphology of the lesion and the solid component (SC) and signal intensity (SI) of the SC. MRI findings were correlated with pathological findings.ResultsThe patients with SBT-MP (mean 26.3 years) were younger than those with typical SBT (mean 44.5 years). Postoperative staging in patients with SBT-MP was II in two and III in two cases, while staging for typical SBT was I in seven, II in one and III in two cases. The morphologic patterns of SBT-MP were a unilateral cystic mass with intracystic mural nodules (CwMN) (n = 2), bilateral solid papillary masses (SM), and bilateral SM with CwMN. The pattern of typical SBT was CwMN (n = 13) in all but one lesion (SM with CwMN). All SCs showed inhomogeneous slight hyperintensity on T2 weighted images (WI) and high SI on diffusion-WI (DWI) except for in one typical SBT. Although diffuse proliferation of the tumor cells in micropapillary projections with little stroma seemed to correspond to inhomogeneous slightly hyperintense foci in SC on T2WI and high SI on DWI, similar MR findings were observed in typical SBT in all lesions on T2WI and 11 of 12 lesions on DWI. In typical SBT, inhomogeneous slightly hyperintense foci in SC on T2WI and high SI on DWI corresponded to highly cellular foci with densely branched papillae.ConclusionPathological findings and clinical behavior of SBT-MP differed from those of typical SBT, but morphology and SI of SC on MRI were similar, with papillary projections demonstrating inhomogeneous slight hyperintensity on T2WI and high SI on DWI.

Borderline Brenner tumor with a concomitant mucinous tumor of the ovary: a case report

Brenner tumors (BTs) are rare ovarian tumors which are a part of the epithelial stromal tumor group of ovarian neoplasms. Most of the BTs are benign and usually asymptomatic. BTs stand for the 1.4-2.5% of ovarian tumors. Of the BTs, not more than 2% exhibit characteristics of borderline (or malignant) BTs. Borderline BTs are usually bigger than benign BTs and individuals typically represent with symptoms related with an unilateral ovarian mass. BTs are often related with mucinous cystadenomas or seldomly cystadenocarcinomas. We present a case of borderline BT associated with a concomitant mucinous ovarian tumor.

Difference of lower airway microbiome in bilateral protected specimen brush between lung cancer patients with unilateral lobar masses and control subjects.

The functional role of respiratory microbiota has attracted an accumulating attention recently. However, the role of respiratory microbiome in lung carcinogenesis is mostly unknown. Our study aimed to characterize and compare bilateral lower airway microbiome of lung cancer patients with unilateral lobar masses and control subjects. Protected bronchial specimen brushing samples were collected from 24 lung cancer patients with unilateral lobar masses (paired samples from cancerous site and the contralateral noncancerous site) and 18 healthy controls undergoing bronchoscopies and further analyzed by 16S rRNA amplicon sequencing. As results, significant decreases in microbial diversity were observed in patients with lung cancer in comparison to the controls, alpha diversity steadily declined from healthy site to noncancerous to cancerous site. Genus Streptococcus was significantly more abundant in cancer cases than the controls, while Staphylococcus was more abundant in the controls. The area under the curve of genus Streptococcus used to predict lung cancer was 0.693 (sensitivity = 87.5%, specificity = 55.6%). The abundance of genus Streptococcus and Neisseria displayed an increasing trend whereas Staphylococcus and Dialister gradually declined from healthy to noncancerous to cancerous site. Collectively, lung cancer-associated microbiota profile is distinct from that found in healthy controls, and the altered cancer-associated microbiota is not restricted to tumor tissue. The genus Streptococcus was abundant in lung cancer patients and exhibited moderate classification potential. The gradual microbiota profile shift from healthy site to noncancerous to paired cancerous site suggested a change of the microenvironment associated with the development of lung cancer.

Endoscopic endonasal resection of a nasal meningoencephalocele - Case report

Abstract Nasal meningoencephaloceles are rare findings, represented by protrusions of intracranial contents into the nasal cavity. They present as unilateral masses, and commonly determine unilateral nasal obstruction, rhinorrhea and non-characteristic headaches. We present the case of a 34-year-old patient diagnosed with a posttraumatic transethmoidal meningoencephalocele. The patient presented with unilateral nasal obstruction, mild headache and episodic watery rhinorrhea. The treatment was endoscopic endonasal surgical excision and repair of the skull base defect, in a mixt ENT-neurosurgical team. Patient follow-up showed no remaining mass or symptoms and normal closure of the skull base defect.

POLYPOID NASAL MASSES;

Objectives: The purpose of this study is firstly to signify the occurrence ofunusual nasal polypoid masses by analyzing their histopathological spectrum and to be on thelookout for them. Secondly to highlight the fact that nasal polypoid masses should not be takenlightly as they may be representing an underlying grave pathological process meriting urgentmedical advice. Study Design: Retrospective/observational study. Setting: Charsada TeachingHospital affiliated with Jinnah Medical College Peshawar. Period: March 2010 to March 2015.Methods: In this study, all the surgical pathology cases with clinical diagnosis of nasal polypswith no suspicion for malignancy were retrieved from archives of Charsada Teaching Hospitalaffiliated with Jinnah Medical College Peshawar. The slides and diagnoses of all the retrievedcases were reviewed. The number of cases for each diagnostic category were recorded andanalyzed according to the non-neoplastic, neoplastic and their subcategories. Results: Thereview of cases from March 2010- March 2015 showed that most of the polypoid masses werenon-neoplastic, while only few were neoplastic. Of all the non-neoplastic masses, inflammatory/allergic polyps were much more common followed bypolyps with fungal infections andeosinophilic angiocentric fibrosis. Amongst the neoplastic masses, benign tumors were morecommon than the malignant. The benign masses comprised of hemangioma, angiofibroma,inverted papilloma and schwannoma. The malignant nasal masses constituted one case eachof polypoid extraskeletal Ewings sacoma, plasmacytoma, non-Hodgkin lymphoma and renalcell carcinoma. Conclusions: Awareness about the occurrence of the usual and unusualentities in the nasal cavities needs to be increased. Important diagnostic categories requiringurgent management include polyps with invasive fungal infection, inverted papilloma and allmalignant cases. Therefore, all unilateral nasal cavity masses with frequent epistaxis, pain orbone erosions should be submitted for histopathological examination.