Luiz Augusto Nascimento

Neoplasias de glândulas salivares: estudo de 119 casos

BACKGROUND: The purpose of this study was to review clinicopathological aspects of salivary glands tumours from 1980 through 1997 at Departament of Pathology of Paulista School of Medicine - Federal University of Sao Paulo - Unifesp. METHODS: We retrospectively evaluated 205.967 pathological reports and we found 119 salivary gland tumours, 93 benign neoplasms (78%) and 26 malignant tumours (22%). RESULTS: The age range was 6-74 years (mean age 40 years), 71 cases were in female (60%) and 48 cases were in male (40 %). The distribution of tumours in various sites were 84 cases of parotid tumours (70.6%), 23 cases of submandibular (19.3%), 11 cases of minor (oropharyngeal) glands (9.24%) and just one case of sublingual gland tumour (0.86%) . Pleomorphic adenoma forming 59.7% of the total salivary gland tumours, Warthins tumour forming 10% of the series, adenoid cystic carcinoma forming 9.3% and mucoepidermoid carcinoma forming 8.4%. CONCLUSIONS: Some aspects like distribution of tumour in relation to the site and histopathological pattern are very important to considered in the treatment of the disease and prognosis.

Obstructive sleep apnea in patients undergoing supracricoid horizontal or frontolateral vertical partial laryngectomy

OBJECTIVE: To assess obstructive sleep apnea (OSA) in patients undergoing supracricoid horizontal partial laryngectomy (SCPL) or frontolateral vertical partial laryngectomy (VPL) for the treatment of laryngeal carcinoma and correlate it with age, body mass index, physical examination, and upper airway evaluation. STUDY DESIGN AND SETTING: A prospective study was carried out involving 22 patients between 50 and 80 years of age divided into 2 equal groups. The patients underwent SCPL and VPL, and were evaluated by anamnesis, otolaryngologic examinations, nasopharyngolaryngoscopy, and polysomnography. RESULTS: A significant direct correlation was observed between the apnea/hypopnea index (AHI) and age of the patients. An inversely proportional relation was found between glottic opening and AHI. The presence of OSA was 81% in SCPL and 91% in VPL. CONCLUSION: We observed a high incidence of OSA in patients undergoing SCPL and VPL.

Frontal sinus adenocarcinoma

CONTEXTnParanasal sinus cancer is considered rare, with an incidence of less than 1 per 100,000 per year, with the frontal sinus being the primary site in only 0.3%. We report a case of adenocarcinoma arising in the frontal sinus.nnnDESIGNnCase report.nnnCASE REPORTnA 59-year-old woman, secretary, came in February 1998 with a 4-month history of low intensity frontal headache. She denied contact with wood dust. On examination a non-tender swelling was noted over her right forehead next to the medial aspect of the right orbit. CT scan showed a soft-tissue mass involving frontal sinus with intracranial invasion through the posterior wall. The anterior ethmoid sinus and the medial aspect of the right orbit were also involved. MRI demonstrated dural thickening in communication with the frontal mass. She underwent an en-bloc tumor resection by craniotomy including orbital clearance. Histology revealed an adenocarcinoma. After surgery she had tumor recurrence, and chemotherapy and radiotherapy were started resulting in partial improvement.

Isolated Schwannoma of the Olfactory Groove: A Case Report

Introductionu2003Schwannoma of the olfactory groove is an extremely rare tumor that can share a differential diagnosis with meningioma or neuroblastoma. Objectivesu2003The authors present a case of giant schwannoma involving the anterior cranial fossa and ethmoid sinuses. Case Reportu2003The patient presented with a 30-month history of left nasal obstruction, anosmia, and sporadic ipsilateral bleeding. Computed tomography of the paranasal sinuses revealed expansive lesion on the left nasal cavity extending to nasopharynx up to ethmoid and sphenoid sinuses bilaterally with intraorbital and parasellar extension to the skull base. Magnetic resonance imaging scan confirmed the expansive tumor without dural penetration. Biopsy revealed no evidence of malignancy and probable neural cell. Bifrontal craniotomy was performed combined with lateral rhinotomy (Weber-Ferguson approach), and the lesion was totally removed. The tumor measured 8.0u2009×u20094.3u2009×u20093.7 cm and microscopically appeared as a schwannoma composed of interwoven bundles of elongated cells (Antoni A regions) mixed with less cellular regions (Antoni B). Immunohistochemical study stained intensively for vimentin and S-100. Conclusionu2003Schwannomas of the olfactory groove are extremely rare, and the findings of origin of this tumor is still uncertain but recent studies point most probably to the meningeal branches of trigeminal nerve or anterior ethmoidal nerves.

Synchronous Bilateral Warthin Tumors: A Case Report

Introductionu2003Warthin tumor is described as papillary cystadenoma lymphomatosum and is the second most common tumor of the parotid glands. Bilateral synchronous incidence is rare, occurring in 7 to 10% of the cases. It is more common in males between 60 and 70 years of age and is closely related to smoking. There is slow growth and the condition is a delimited nodule of regular outlines; it has low rates of malignant progression and recurrence. Objectiveu2003Report a case of synchronous bilateral Warthin tumor occurring in an elderly patient, and review incidence and peculiarities of this tumor. Case Reportu2003A 78-year-old man who used to smoke had a history of mild pain in the topography of right parotid three weeks ago. Patient with hypertension, diabetes and a longtime smoker (smoking a pack per day for 32 years) noticed a progressive bulging in the right parotid region for about 2.5 years ago, and noticed another progressive bulging (althought in the left parotid region), for about one year ago. Patient denied fever, redness, skin lesions and pain during this period until last three weeks, when he sought medical attention for a mild pain in the right facial region. The patient underwent cervical magnetic resonance imaging that showed tumor lesions in both parotids. Fine needle aspiration revealed a typical lesion of epithelial oxyphilic cells associated with reactive lymphoid proliferation, suggesting Warthin tumor. The patient underwent two superficial parotidectomies, and the histopathologic result from both tumors of parotid glands showed papillary cystadenoma lymphomatosum. Conclusionu2003The occurrence of synchronous bilateral Warthin tumor is extremely rare, and anamnesis and physical examination, as well as some complementary examinations, are important means for diagnostic evaluation. Confirmation of the diagnosis can only be obtained through a histopathologic study. A superficial or total parotidectomy is the recommended treatment for the disease.