Hiromichi Shirato

Salivary duct carcinoma: a case report with cytological and pathological features

A 55-year-old Japanese man presented with rapidly growing tumor in the left parotid region without any symptoms. Based on the fine-needle aspiration cytology report of parotid epithelial malignant tumor (suggestive of salivary duct carcinoma), the left parotidectomy was performed. Histopathology and immunohistochemistry examinations revealed features of salivary duct carcinoma. Although salivary duct carcinoma comprising a small proportion of salivary gland tumors and is known to be aggressive, he is free from recurrence and metastases 36 months after the surgery and radiation therapy.

Malignant Melanoma Arising in the Nasal Cavity.

Malignant melanoma arising in the nasal cavity is a rare condition with a poor prognosis. Three cases, all females, aged 62, 73, and 94, were treated in our department from 1992 to 1995.One of these was a case of amelanotic melanoma that could not be positively diagnosed as malignant melanoma before immunohistochemical staining for S-100 protein, and Fontana-Massons staining, had been done.In three cases radical surgery was peformed with pre- or postoperative chemotherapy and immunotherapy (cryosurgery and/or interferon). Two of the patients experienced recurrence, and salvage therapy was subsequently performed.All three are currently alive. The patient survival period ranged from 12 to 46 months after the initial therapy. The present protocol may be a useful approach to obtaining local control, however, the number of patients studied was too small, and the period after initial treatment too short, for conclusive statements on this matter.

Giant Cell Tumor of the Sphenoid Sinus. A Case Report.

A 26-year-old man presented with double vision and headache. Neurological examination revealed impairment of cranial nerves II, III, VI. Bony destruction of the sphenoid sinus as well as the sella-clival region was seen on plain craniogram X-ray films. CT scan showed an enhanced mass in the sphenoid sinus. MRI showed a clear localization of the tumor which involved the surrounding tissues. The contents of the sphenoid sinus could be removed by curettage via a transseptal approach. The histological diagnosis was giant cell tumor. The cranial symptoms were relieved within a few days postoperatively. He has remained asymptomatic for 24 months since the operation.

The combination therapy (tranilast and alterative treatment) in nasal allergy.

Sixteen patients with perennial nasal allergy were treated with tranilast combined with histamine γ-globulin conjugate for more than 4 weeks. Improvement was observed in 75% of the patients for sneezing, 71.4% for nasal discharge, 80% for nasal obstruction, 73.3% for swelling of the inferior turbinate, and 80% for the amount of nasal discharge.The global utility of this combination therapy was rated as “moderate to marked effectiveness” in 56.3% and as “slight to marked effectiveness” in 81.3%. Marked improvement of subjective symptoms was observed with this combination therapy, as compared with the tranilast treatment alone. Stomatitis was noted in 1 case but not severe enough to require discontinuation of the medication.It was thus concluded that this combination therapy is useful for treatment of perennial nasal allergy.