Search Results (42)

Background/Objectives: Schwannoma is a rare tumor, typical in young adults, originating from the myelin sheath that surrounds Schwann cells. It can occur in any part of the Peripheral Nervous System (PNS). It develops in the head and neck region in 25–48% of cases, and the eighth pair of cranial nerves (vestibulocochlear nerves) are the most hit (vestibular schwannoma). Oral cavity involvement is exceedingly rare, accounting for about 1–2% of all cases. The most affected oral site is the tongue, especially its anterior third, while localization on the lip is one of the least common sites for the development of this lesion. Case Presentation: A lower lip schwannoma on a 17-year-old boy, present for about 7 years, was documented. Material and Methods: PubMed and Google Scholar were used as research engines; English scientific works published in the last 20 years (2005–2024) regarding oral cavity involvement, using the keywords “Schwannoma”, “Oral Schwannoma”, “Pediatric Oral Schwannoma”, and “Schwannoma of the lip”, were considered. Results: In total, 805 and 16,890 items were found on PubMed and Google Scholar search engines, respectively. After title, abstract, full text evaluation, and elimination of duplicates, 26 articles were included in the review process. Discussion: Clinically, oral schwannoma presents as an asymptomatic hard–elastic fluctuating mass, often misdiagnosed on the lip as a traumatic or inflammatory lesion (e.g., mucocele). Biopsy is mandatory, and histological examination reveals positivity to the neuronal marker S-100. Conclusions: Complete excision also prevents recurrence. Malignant transformation is extremely rare. Full article

Two geriatric (>9 years old) dogs presented with vomiting, depression, and anorexia and were diagnosed with extrahepatic biliary obstruction (EHBO) secondary to ruptured gallbladder mucoceles. Diagnosis was based on serum biochemical analysis, abdominal radiography, and ultrasonography, which revealed gallbladder rupture, peritonitis, and common bile duct dilation. Both dogs underwent emergency surgical intervention involving cholecystectomy and choledochal stent placement in the common bile duct without cholecystojejunostomy or cholecystoduodenostomy. Postoperatively, the clinical symptoms and serum chemistry values improved, and both dogs survived without recurrence for over one year. These cases demonstrate that choledochal stenting can be an effective adjunct to cholecystectomy for managing EHBO in dogs with ruptured gallbladder mucoceles, potentially preventing reocclusion and promoting recovery, especially when histopathological evaluation is not feasible in clinical settings. However, persistent elevation of liver enzymes may occur postoperatively, necessitating prolonged monitoring and medical management in some cases. Full article

Background: The relationship between dental implants and sinus mucoceles is an area of growing interest in oral and maxillofacial surgery, as therapeutic approaches for these conditions remain controversial. This case report presents a 48-year-old male with no significant medical history who sought dental care due to recurrent abscesses on the distal abutment of a five-unit maxillary bridge. Clinical and radiographic evaluations, including Cone-Beam Computed Tomography (CBCT), revealed a pathologic lesion associated with the second molar, insufficient alveolar bone height in the posterior maxilla, and a radiopaque mass on the sinus floor. Methods: A one-stage surgical approach was planned, involving the second molar extraction, the sinus cyst removal, sinus floor elevation, and simultaneous implant placement. The prosthetic restoration was completed six months postoperatively. Results: Over an 88-month follow-up period, no prosthetic complications were observed, and the patient reported high satisfaction with the restoration’s function and aesthetics. Conclusions: This case highlights a single-stage surgical strategy’s feasibility and long-term success in managing asymptomatic maxillary sinus mucoceles while optimizing implant placement and rehabilitation. Full article

This report describes a rare occurrence of benign fibrous histiocytoma in the frontal sinus of a 38-year-old male. The patient presented with acute symptoms, including sudden-onset headache, nausea, and general discomfort, although neurological, otorhinolaryngological and laboratory examinations showed no abnormalities. A cranial CT scan revealed a cystic, osteodestructive lesion measuring 2.5 cm in the far lateral right frontal sinus, initially suspected to be a mucocele due to radiological characteristics and the patient’s history of recurring frontal headaches and retrobulbar pressure. Elective surgical excision was performed via an external supraorbital approach due to the lesion’s lateral location. Histopathological examination of the excised tissue revealed characteristic features of benign fibrous histiocytoma, including spindle cell proliferation and the presence of histiocytes and siderophages. Immunohistochemistry further supported the diagnosis, showing EMA, S100, and creatinine negativity with SMA positivity. This case is unique, as it represents the first reported benign fibrous histiocytoma in the frontal sinus. During regular follow-up, the patient remained symptom-free and showed no recurrence. This report underscores the importance of considering rare diagnoses for cystic skull lesions and supports tailored surgical approaches based on lesion location. Full article

Gallbladder mucocele, cholelithiasis, choledocholithiasis, and cholecystitis are significant contributors to morbidity and mortality in dogs. The exact etiology of these conditions remains poorly understood, though various factors, such as endocrinopathies, dyslipidemia, and impaired gallbladder motility, have been suggested as potential contributors. Surgical intervention has been described as the first choice of treatment when biliary rupture or obstruction is suspected; however, medical management may be an important part of therapeutic or preventative strategy. Reports of medical management typically involve the use of a choleretic used to stimulate the flow of bile into the duodenum or substances that act as a “hepatoprotective” agent such as S-adenosylmethionine. In people, some nutrients appear to modify bile flow and are used as agents in the prevention and treatment of these conditions in the gallbladder. This paper provides a review of the literature about possible nutritional factors involved in the pathogenesis and treatment of canine gallbladder mucocele and cholelithiasis. Opportunities for the prevention and treatment of common biliary diseases in dogs may include the reduction of dietary fat, control of hyperlipidemia with omega-3 and fiber supplementation, ensuring an adequate supply of amino acids such as methionine and tryptophan, and the evaluation of vitamins such as vitamin D. Full article

Background/Objectives: Periostin’s role in the pathogenesis of inflammatory diseases, particularly in the nose and paranasal sinuses, is an area of growing interest. This study aims to evaluate the expression of periostin in mucoceles, inverted papillomas, choanopolyps and retention cysts. Methods: Tissue samples collected during functional endoscopic sinus surgery (FESS) were analyzed for POSTN gene mRNA expression using qPCR. Periostin protein levels were measured via ELISA and Western Blot. Serum periostin levels were also assessed through ELISA in both patients (n = 54) and controls (n = 12). Results: A total of 66 participants were recruited, including 18 with inverted papillomas, 10 with mucoceles, 10 with choanopolyps, 16 with retention cysts and 12 controls. There were no significant alternations between tissue and serum samples of inverted papilloma compared to the control group. Choanopolyp tissues exhibited elevated POSTN protein expression, though POSTN mRNA and serum levels remained unchanged. In mucoceles, periostin levels were significantly elevated in both tissues and serum. Retention cyst tissues demonstrated an increase in POSTN mRNA and protein expression, whereas serum periostin levels remained consistent with those observed in the control group. Conclusions: The findings suggest that periostin may play a role in the pathophysiology of benign non-neoplastic lesions of the nose and paranasal sinuses such as mucoceles, retention cysts and choanopolyps, highlighting a need for more investigation in this subject. Full article

Background: Nasal and paranasal sinus masses can arise from a wide range of conditions, both benign and malignant, as well as congenital or acquired. Diagnosing these masses is often challenging, requiring a combination of nasal endoscopy, imaging studies, and histopathological analysis. Initial imaging frequently involves computed tomography or cone beam computed tomography (CBCT) to evaluate the bony anatomy of the nasal cavity and surrounding sinuses, while magnetic resonance imaging (MRI) is typically used for detailed assessment of soft tissues and to aid in differential diagnosis when the findings are inconclusive. Methods: This review examines nasal masses evaluated using CT, CBCT, and MRI, highlighting key imaging features that may assist in differential diagnosis. Results: For non-neoplastic lesions, examples include conditions such as rhinoliths, inverted mesiodens, and septal mucoceles. Benign and borderline tumors discussed encompass lobular capillary hemangioma, inverted papilloma, septal osteoma, chondromesenchymal hamartoma, hemangioma, hemangiopericytoma, antrochoanal polyp, sinonasal angiofibroma, ossifying fibroma, and lipoma. Malignant tumors addressed in this review include adenocarcinoma, esthesioneuroblastoma, non-Hodgkin lymphoma, melanoma, and sarcoma. Conclusions: Diagnosing nasal lesions represent a significant challenge for otolaryngologists. Imaging characteristics of nasal masses play a crucial role in narrowing down differential diagnoses before surgery. However, nasal endoscopy combined with biopsy remains the definitive diagnostic approach. Full article

Mucocele of the appendix and pseudomyxoma peritonei are rare diseases. The clinical findings are nonspecific in the early stages of the disease. The sequelae of appendiceal mucocele, its perforation, and extensive peritoneal involvement via pseudomyxoma peritonei (jelly belly) are repeatedly described in the literature. We present the typical findings in the natural history of the disease. Full article

Appendiceal mucocele is a rare entity first described by Carl von Rokitansky, characterized by cystic dilatation of the appendiceal lumen due to obstruction, epithelial proliferation or inflammation and accumulation of mucoid material. The cause can be either neoplastic or non-neoplastic. Patients with appendiceal mucocele can be asymptomatic or present with right lower quadrant pain which may mimic acute appendicitis. We present the case of a 68-year-old male, who presented to the Emergency Room with a two-day history of right lower quadrant pain, nausea, vomiting and loss of appetite. Abdominal examination revealed tenderness over the Mc Burney point with localized guarding and laboratory results showed leukocytosis with neutrophilia. The abdominal computed tomography revealed a cystic dilated appendix, with a length of 130 mm and a diameter of 75 mm, situated ascending retrocecal and associating peri-appendicular inflammatory changes. The patient underwent right hemicolectomy with side-to-side ileo-colonic anastomosis, due to a wide intraluminal communication between the appendix and the cecum and the inflammation of both structures. Histopathological examination showed both high-grade and low-grade appendiceal mucinous neoplasm. Full article

We report a rare case of low-grade appendiceal mucinous neoplasm (LAMN) causing ileocolic intussusception. The case underscores the importance of considering ileocolic intussusception in differential diagnoses for nonspecific gastrointestinal symptoms. Early diagnosis via contrast-enhanced CT and scrupulous surgical intervention are crucial for favorable outcomes. Full article

Salivary glands’ neoplasms are hard to diagnose and present a complex etiology. However, several viruses have been detected in these neoplasms, such as HCMV, which can play a role in certain cancers through oncomodulation. The co-infections between HCMV with betaherpesviruses (HHV-6 and HHV-7) and polyomaviruses (JCV and BKV) has been investigated. The aim of the current study is to describe the frequency of HCMV and co-infections in patients presenting neoplastic and non-neoplastic lesions, including in the salivary gland. Multiplex quantitative polymerase chain reaction was used for betaherpesvirus and polyomavirus quantification purposes after DNA extraction. In total, 50.7% of the 67 analyzed samples were mucocele, 40.3% were adenoma pleomorphic, and 8.9% were mucoepidermoid carcinoma. Overall, 20.9% of samples presented triple-infections with HCMV/HHV-6/HHV-7, whereas 9.0% were co-infections with HCMV/HHV-6 and HCMV/HHV-7. The largest number of co-infections was detected in pleomorphic adenoma cases. All samples tested negative for polyomaviruses, such as BKV and JCV. It was possible to conclude that HCMV can be abundant in salivary gland lesions. A high viral load can be useful to help better understand the etiological role played by viruses in these lesions. A lack of JCV and BKV in the samples analyzed herein does not rule out the involvement of these viruses in one or more salivary gland lesion subtypes. Full article

Study Design: Retrospective cohort study. Objective: Frontal sinus fractures (FSFs) can lead to a range of clinical challenges, including facial deformity, impaired facial sensation, cerebrospinal fluid (CSF) leakage, sinus drainage impairment, chronic sinus pain and mucocele formation. The optimal management approach, whether surgical or conservative, remains a topic of ongoing discussion. The aim of this study was to evaluate and compare the functional and esthetic outcomes of patients with surgically and conservatively treated FSFs. Methods: In this retrospective study, patients treated for FSFs at the Karolinska university hospital 2004 to 2020 were identified in hospital records and invited to participate in a long-term follow-up. Sequelae and satisfaction with the esthetic result were assessed trough questionnaires and physical examinations. Results: A total of 93 patients were included in the study, with 49 presenting isolated anterior wall fractures and 44 presenting combined anterior and posterior wall fractures. Surgical intervention was performed in 45 cases, while 48 were managed conservatively. Among patients with moderate anterior wall fractures (4–6 mm dislocation), 80% of surgically treated patients compared to 100% of conservatively treated patients expressed satisfactionwith their cosmetic outcomes at follow-up (p = 0.03). In conservatively treated patients with a forehead impression, the anterior wall fracture dislocation ranged from 5.3 to 6.0 mm (p < 0.0001). Approximately 50% of surgically treated patients vs 15% of conservatively treated patients developed impaired forehead sensation at follow-up (p = 0.03). Thirty-six percent of surgically treated patients reported dissatisfaction with surgery-related scarring, particularly those who underwent surgery via laceration or bicoronal incision. Conclusions: This study suggests that anterior FSFs with a dislocation of 5 mm or less can be effectively managed conservatively with high patient satisfaction, low risk of long-term forehead sensation impairment and without potential development of forehead impression. Bicoronal incision or incision via a laceration may be associated with esthetic dissatisfaction and late sequelae such as alopecia. Full article

Background. Pseudomyxoma peritonei (PMP) is a rare, progressive, slowly growing, inadequately understood neoplasm with a 5-year progression-free survival rate of as low as 48%. It is characterized by varying degrees of malignancy and the production of mucinous and gelatinous structures. Typically, the development of pseudomyxoma peritonei is associated with the rupture of appendiceal mucinous tumors and other gastrointestinal or ovarian mucinous tumors. The goal of our literature review was to identify various aspects that characterize the ovarian causes of pseudomyxoma peritonei. Materials and methods. The authors performed an extensive literature search between 1 February 2024 and 2 March 2024 on the following databases: Pubmed, Scopus, Oxford Journals, and Reaxys, and the findings were summarized into seven main clinical and paraclinical situations. Results. According to our research, the main instances in which pseudomyxoma peritonei can be triggered by an ovarian cause are the following: (1) mucinous cystadenoma; (2) mucinous ovarian cancer; (3) colon cancer with ovarian metastasis; (4) malignant transformation of an ovarian primary mature cystic teratoma; (5) appendiceal mucocele with peritoneal dissemination mimicking an ovarian tumor with peritoneal carcinomatosis; (6) mucinous borderline tumor developing inside an ovarian teratoma; and (7) the association between a mucinous bilateral ovarian cancer and a colonic tumor. Conclusions. In our study, we aimed to provide a comprehensive overview of the ovarian causes of pseudomyxoma peritonei, including its epidemiology, imagery characteristics, symptoms, current treatment, and promising future therapies, in the hopes of finding feasible solutions, as a lack of understanding of this mucus-secreting malignant disease increases the risk of delayed diagnosis or uncontrolled deterioration. Full article

Background and Objectives: Chronic sinusitis is a commonly encountered diagnosis for otorhinolaryngologists. The profound negative effect of rhinosinusitis on patients’ quality of life is frequently overlooked, and surgical lines of treatment are numerous. The aim of the study was to assess the comparative efficacy of endoscopic middle meatal antrostomy with the endoscopic prelacrimal recess approach, combined with middle meatal antrostomy in the treatment of unilateral chronic maxillary sinus lesion. Materials and Methods: Thirty patients with unilateral chronic maxillary sinus lesions enrolled in the study at Alahsa hospital. Patients were divided into two groups: 15 treated through a middle meatal antrostomy and 15 treated via a combined middle meatal antrostomy and prelacrimal recess approach. Demographic and clinical information of the patients, including the medical history, CT scan findings, diagnosis, recurrence, and complications, were gathered and analyzed. Pre- and postoperative clinical findings were graded utilizing the Lund–Kennedy Endoscopic Scoring System. Results: The enrolled patients varied in age from 18 to 56, with 60% being male and 40% being female. Antrochoanal polyp, maxillary sinus mucocele, and unilateral allergic fungal sinusitis were among the pathological diagnoses. The follow-up period averaged 14.3 months. Following surgery, two patients in Group II encountered nasal discomfort, which included synechia and epiphora. The success rate for preserving a patient’s disease-free condition was 86.7%. A statistically significant difference in disease-free incidence was observed among the patients in group II. In group I, recurrence was identified in 26.7% of the patients. The postoperative symptoms diminished considerably, and the VAS score was reduced substantially. In Group II patients, however, there was no significant difference in scarring. Clinically significant differences were observed in the mean total Lund–Kennedy Endoscopic scores when compared to their preoperative values. Conclusions: Achieving endoscopic access to the sinus’s anterior, lateral, inferior, and inferomedial regions is facilitated by operating via the prelacrimal recess, which is the most advantageous approach. This approach facilitates rapid mucosal healing by maintaining the integrity of the nasolacrimal duct and mucosal covering. The specific pathology, surgical objectives, surgeon expertise, and equipment accessibility influence the choice of endoscopic surgical technique. Full article

Well-defined, faintly radiopaque lesions are occasionally observed in the antrum of the maxillary sinus in asymptomatic patients during maxillary sinus floor elevation. These lesions are treated as antral pseudocysts (AP) based on the clinical diagnosis in some cases, and maxillary sinus floor elevation is performed without enucleating these lesions. However, further surgery is required after implant placement if the lesion is a mucocele, odontogenic cyst, or tumour. This comprehensive clinical review aimed to identify an appropriate approach for maxillary sinus floor elevation in patients with well-defined, faintly radiopaque lesions in the antrum based on our clinical experience. Full article