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Results for “Ear Neoplasms”

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PubMed1994

[Adenomatous neoplasia of the middle ear].

Adenomatous neoplasm occurring in the middle ear is rare. The clinical findings are non-specific and include otological symptoms as well as sometimes functional deficits of the lower cranial nerves. The final diagnosis will be made only after elaborate histological examinations because of the inconsistent radiological and clinical findings. DNA analysis yields some information on the prognosis of this tumour. We report on a case where a primary adenomatous neoplasm developed in the middle ear, and discuss our concept of therapy.

Adenoma↗
PubMed1980

Cutaneous carcinoma of the auricular and periauricular region.

Cutaneous carcinoma of the auricular and periauricular region can be diagnosed early and often cured; however, many of these tumors become difficult to treat because of local spread and regional metastasis. We have treated 122 patients with 145 cutaneous carcinomas of the auricular and periauricular region with either Mohs' histographic surgery or conventional excision with total microscopic marginal control. Inherent in these treatment modalities is the construction of detailed serial tissue maps for each tumor. From these maps, a three-dimensional composite for each tumor is derived, giving information about the direction of local spread of the tumors. The tumors have been found to extend locally through soft tissue into perichondrial, periosteal, and neurovascular planes, allowing for more distant occult spread. This knowledge of such patterns of tumor spread can be useful in planning treatment.

Basal Cell Carcinoma↗
PubMed1980

Basal cell carcinoma of the head and neck: identification of the high risk patient.

While the majority of patients with basal cell carcinoma are cured by the initial therapeutic approach, high risk patients who have had recurrences of basal cell carcinoma have been identified. From April 1976 to November 1979, 811 patients with 1,271 cutaneous carcinomas were seen at the Mohs' Histographic Surgery Unit of the Cleveland Clinic Foundation. Of these, 496 represented recurrent basal cell carcinomas. Histologic subtype, location of the tumor, and age of the patient were studied in an attempt to identify factors which place patients at risk for persistent or recurrent carcinoma. The physician who first sees a patient with basal cell carcinoma should look for these risk factors and, after identifying such patients, consider an aggressive management with frequent follow-up.

Adult↗
PubMed1992

A theory of site distribution of melanomas: Queensland, Australia.

Although sun exposure is believed to be associated causally with cutaneous melanoma, the high incidence on less sun-exposed areas such as the back, as well as on chronically exposed sites such as the face, suggests that the association with sunlight is less straightforward than for other skin cancers. To explain this enigmatic site distribution, a theory of site-dependent susceptibility of melanocytes to malignant transformation is proposed. As possible evidence, all melanomas diagnosed in the state of Queensland, Australia, over a one-year period were surveyed for histologic evidence of benign melanocytic nevus cells adjacent to the melanoma, and analyzed according to anatomic distribution. Results showed a regional variation in the proportion of melanomas with adjacent nevi not explicable by regional variation in nevus density, which suggests that there is a varying susceptibility of nevi to malignant change. Given that nevus cells are equivalent to melanocytes, this finding would support the hypothesis that melanocytes at-large have a differential response to the mitogenic stimulus of sunlight according to anatomic site.

Adult↗
PubMed2006

[Interstitial brachytherapy of peri-orificial skin carcinomas on the face].

Purpose. - To analyse outcomes after interstitial brachytherapy of facial periorificial skin carcinomas. Patients and methods. - We performed a retrospective analysis of 97 skin carcinomas (88 basal cell carcinomas (BCCs), 9 squamous cell carcinomas (SCCs)) of the nose, periorbital areas and ears from 40 previously untreated patients (group 1) and 57 patients who had undergone surgery (group 2). The average dose was 55 Gy [50-65] in group 1 and 52 Gy [50-60] in group 2 (mean implantation times: 79 and 74 hours respectively). We calculated survival rates and assessed functional and cosmetic results de visu. Results. - Median age was 71 years [17-97]. There were 29 T1, 8 T2, 1 T3 and 2 Tx tumors in group 1. Tumors were<2 cm in group 2. Local control was 92.5% in group 1 and 88% in group 2 (median follow-up: 55 months [6-132]). Five-year disease-free survival was better in group 1 (91% [75-97]) than in group 2 (80% [62-90]), P=0.23. Of the 34 patients whose results were re-assessed, eight presented pruritus or epiphora. One group 2 patient had an impaired eyelid aperture. Cosmetic results were better in group 1 than in group 2, with respectively 72% (8/11) vs 52% (12/23) of good results and 28 (3/11) vs. 43% (10/23) of fair results. Conclusion. - Brachytherapy provided a high level of local control and good cosmetic results for facial periorificial skin carcinomas that pose problems of surgical reconstruction. Results were better for untreated tumors than for incompletely excised tumors or tumors recurring after surgery.

Adolescent↗
PubMed2002

[Cylindrocarcinoma in a patient with Brooke-Spiegler syndrome].

BACKGROUND: Cutaneous cylindromas are benign adnexal tumors that may occur as a solitary lesion or in a multiple familiar pattern. Malignant change is rare. The association of multiple trichoepitheliomas and cylindromas, the so called Brooke-Spiegler Syndrome, is supposed to be inherited in an autosomal dominant manner. PATIENTS: A 55 year old woman presented with multiple skin tumors on the scalp, as well as the nasolabial and periauricular area since the age of 20 years. Her daughter and her nephew were also affected. Tumors were surgically removed for cosmetic reasons and showed histological signs of benign cylindromas and trichoepitheliomas. 35 years after diagnosis patient presented with a large exulceration on the right occipital area with intracranial invasion. Staging revealed multiple metastases in both lungs. Patient died 1 month later. RESULTS: Histological examination showed beside zones of massive necrosis multiple mitosis. The jigsaw puzzle pattern and the thick PAS positive basal layer, the striking characteristics of benign cylindromas, were lost. These histological findings and the clinical presentation led to the diagnosis of cylindrocarcinoma. CONCLUSIONS: Cylindrocarcinoma is an aggressive tumor with tendency to a local destructive growth and metastases. As malignant transformation of a benign cylindroma occurs more often in the multiple form a close follow-up of patients with multiple cylindromas is necessary. A family study is indicated.

Carcinoma, Adenoid Cystic↗
PubMed2003

Epithelial tumors of the middle ear--are middle ear carcinoids really distinct from middle ear adenomas?

Primary tumors of the middle ear are much less commonly encountered in clinical practice than non-neoplastic lesions such as inflammatory polyps (aural polyps) or cholesteatomas. The rarity of such tumors can complicate attempts, by both clinicians and pathologists, to correctly classify them. It has been customary for many authors to segregate middle ear adenomas (MEAs) from middle ear carcinoids as two discrete benign neoplastic entities. It has become apparent, however, that MEAs and carcinoids of the middle ear share a sufficient number of overlapping pathologic features and similarities of clinical behavior to warrant their collapse into a single diagnostic category. It is proposed that these tumors should be designated as MEAs, which are defined as benign, indolent epithelial tumors of the middle ear that do not invade or erode bone and do not metastasize. The individual tumor cells are cytologically bland and polygonal, columnar or plasmacytoid-shaped; they may be arranged in islands, glandular formations or trabeculae, but not in papillary structures. They are typically keratin- and vimentin-positive immunohistochemically, and are often positive as well with antibodies for chromogranin A, synaptophysin, neuron-specific enolase, Leu-7, serotonin, pancreatic polypeptide and S-100 protein. Dense core neurosecretory granules may be identifiable by electron microscopy. Conservative surgical excision is the treatment of choice, and local recurrence following complete excision is quite uncommon.

Adenoma↗
PubMed2001

Multiple apocrine hidrocystomas: treatment with carbon dioxide laser vaporization.

BACKGROUND: Apocrine hidrocystoma is a benign cystic tumour with apocrine differentiation. Although most cases are solitary tumours, multiple tumours may occur. Surgical removal is the usual treatment for apocrine hidrocystoma, but it may be troublesome and disfiguring in cases with multiple tumours. OBJECTIVE: To determine the efficacy and cosmetic outcome of carbon dioxide laser vaporization in the treatment of multiple apocrine hidrocystomas. PATIENTS AND METHODS: A total of 11 lesions in three adult patients were treated with carbon dioxide laser vaporization using a continuous and defocused mode, with a power density of 5 J/cm(2). The lesions were localized lateral to the outer canthus, on the free edge of the eyelids, and on the ear. Only a single session of treatment was performed for each lesion. Photographic controls were taken before and after treatment. RESULTS: The lesions cleared after laser treatment without residual changes, and a successful cosmetic result was obtained. CONCLUSION: Carbon dioxide laser is an efficient method of the treatment for multiple apocrine hidrocystomas.

Adult↗
PubMed2000

Temporalis muscle flap for craniofacial reconstruction after tumor resection.

Temporalis muscle flap provides a good solution for the reconstruction of craniofacial defects after tumor resection. Nine patients with complicated defects located at the upper two thirds of the face, anterior cranial base, or mastoid region are presented. Five patients had orbital exenteration, two with total maxillectomy and two with anterior craniofacial resection. Temporalis muscle flap provided profuse well-vascularized tissue for the obliteration of orbital exenteration and total maxillectomy cavities and coverage of surface defects. Cranial, oral, and nasal spaces were separated successfully in all patients. Temporalis muscle flap is a very reliable technique with low complication rates and few donor site problems. This safe and technically easy flap can be preferred for the reconstruction of craniofacial defects after ablative tumor surgery, especially in older and debilitated patients.

Aged↗
PubMed1979

Multiple apocrine cystadenomas.

A 56-year-old man had approximately forty apocrine cystadenomas of the face and ears. Clinical examination and light microscopic findings were typical for apocrine cystadenomas. Electron microscopic findings showed an absence of annulate lamellae, thus differing from the only previously reported study. Review of the literature indicates that a large number of apocrine cystadenomas, such as on our patient, has not been reported previously.

Apocrine Glands↗
PubMed1987

An interdisciplinary approach to the management of basal cell carcinoma of the head and neck.

At the University of Michigan the dermatologic surgeon works closely with the head and neck surgeon in resecting extensive cutaneous malignancies that could benefit from the combined skills of both surgical specialists. Mohs surgery offers complete microscopic controlled resection of the cutaneous portion of skin cancers. Tumors extending deeply from the skin into underlying bone and soft tissue are resected with the assistance of the head and neck surgeon familiar with the anatomy and trained in the protection of the vital structures of the head and neck. It is evident that patients with large or aggressive basal cell carcinomas will best be served when this interdisciplinary approach has become commonplace.

Basal Cell Carcinoma↗
PubMed1998

Tie-over bolster dressings may not be necessary to secure small full thickness skin grafts.

BACKGROUND: The accepted method for securing full thickness skin grafts (FTSG) is with a tie-over bolster dressing, with or without basting sutures. We question the need for tie-over bolster dressings for small FTSGs. OBJECTIVE: We describe our method of FTSG reconstruction and the outcome in a consecutive series. METHODS: Thirty patients with surgical defects following tumour excision from the face24, scalp1, ear2, and finger3 ranging in diameter from 8 to 45 mm (mean 20 mm) were reconstructed with a FTSG. Interrupted monofilament nylon perimeter sutures only were used, with antibiotic ointment at the wound edge with either a light dressing or no dressing. RESULTS: A series of 30 FTSG secured without a tie-over bolster dressing or basting sutures is described, all with good to excellent long term results. In two cases there was early superficial necrosis of the graft, but ultimately 100% graft take. CONCLUSION: We have found tie-over bolster dressings and basting sutures to be unnecessary in our series of small FTSG. This technique saves time and material and minimizes handling of the graft.

Adult↗