Yolk sac tumors (YSTs), which are also called endodermal sinus tumors, are malignant tumors of germ cell origin. These tumors usually occur in the gonads, but 20% of cases have been reported at extragonadal sites. The head and neck is a rarely affected region that accounts for just 1% of all malignant tumors of germ cell origin. In addition, YSTs arise mostly in childhood. We present a rare pathologically pure case of primary adult YST in the sinonasal area. A 45-year-old male patient presented with a rapidly growing mass in the nasal cavity, which caused nasal obstruction and bloody post-nasal drip. The histopathologic features indicated pure YST, and immunohistochemical analysis revealed positive reactivity for Sal-like protein 4 and alpha-fetoprotein. Herein, we discuss the clinical, radiologic, and histologic features of this YST and review other cases of sinonasal YST in adults.
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Yolk sac tumor of postpubertal-type does not exhibit immunohistochemical loss of SMARCB1/INI1 and SMARCA4/BRG1…but choriocarcinoma? Costantino Ricci, Francesca Ambrosi, Tania Franceschini, Francesca Giunchi, Eugenia Franchini, Francesco Massari, Veronica Mollica, Federico Mineo Bianchi, Maurizio Colecchia, Andres Martin Acosta, Michelangelo Fiorentino Pathology - Research and Practice.2023; 241: 154269. CrossRef
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Herein we describe two cases of nasal glomus tumor.
Histological findings were typical, save for one which was quite large (3.1 cm in its greatest dimension) with an invasive growth pattern and increased ki-67 labeling index (up to 10%). These features raised a red flag of similarity to a recently described "invasive glomus tumor of nasal cavity", suggesting a more aggressive form of glomus tumor.
However, objective criteria for this possibility is lacking at present and more similar case studies are needed to establish a truly aggressive form of glomus tumor.
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BACKGROUND Metastases to the sinonasal tract are rare but occur for many malignancies. The demographics of sinonasal metastases in Korea aren't well known. METHODS Nine cases of metastases to the sinonasal tract identified at Asan Medical Center from January, 1995 to December, 2007 were reviewed. RESULTS Metastatic carcinomas accounted for 2.4% of sinonasal malignancies and 4.7% of carcinomas. Six kinds of cancer metastasized to the sinonasal tract. They included hepatocellular carcinomas (nasal cavity and maxillary sinus), colonic adenocarcinomas (sphenoid sinus and maxillary sinus), clear cell renal cell carcinoma (nasal cavity), pulmonary small cell carcinoma (nasal cavity), follicular carcinoma of thyroid (sphenoid sinus), and breast ductal carcinoma (maxillary sinus). Primary sites had been known in 7 cases, but follicular carcinoma and one adenocarcinoma were diagnosed after sinus metastases.
Histologically, they had ill-defined borders and involved both mucosae and bones. Microscopic findings were not different from those for the primary tumors. CONCLUSIONS The pattern of sinonasal metastases in Korea are different from western data regarding incidence, site, and type, with hepatocellular carcinoma and the nasal cavity being the most common type and site, respectively. Awareness of the possibility of metastases and their pattern is encouraged when examining sinonasal tumors.
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Metastatic Carcinomas to the Oral Cavity and Oropharynx Su-Jin Shin, Jong-Lyel Roh, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim, Sung Bae Kim, Sang-wook Lee, Kyung-Ja Cho Korean Journal of Pathology.2012; 46(3): 266. CrossRef
Encephalocele and nasal glioma are rare, benign congenital neuroectodennal tumors which result from a failure of embryologic sepearation of neuroectodermal and ectodemlal tissues. Nasal glioma should be differentiated from a true glioma, and from a primary encephalocele, which is a herniation of the cranial contents through a bony defect in the skull. For this reason, nasal cerebral heterotopia is a preferred term. We report an unusual case of a nasal mass that was histologically indistinguishable from nasal cerebral heterotopia but proved to be connected to the skull base by fibrotic cord. The patient was a 2 year old girl who had had a slow growing palpable mass in the left epicanthal area for three months.
Nasal chondromesenchymal hamartoma is a distinctive mixed mesenchymal lesion of sinonasal region with a complex histologic appearance and benign clinical course and clinicopathologically similar to those of the mesenchymal hamartoma of the chest wall of infancy. We report a case of nasal chondromesenchymal hamartoma occurred in the right nasal cavity in a 3-month-old female. She was admitted with a history of profuse nasal bleeding and obstruction. CT revealed complex solid and cystic mass, measuring 3.5x2.5x2.5 cm in dimensions which filled the right nasal cavity and extended into ethmoid sinus and cribriform plate.
The received piecemeal fragments of tissue were brown tan-colored firm semitranslucent tissue with a cartilaginous appearance. Microscopically, the basic morphologic elements were irregular islands of hyaline cartilage and myxoid to spindle cell stroma with various cellularity.
The acinic cell carcinoma (ACC) is very rare in the nasal cavity. A 57-year-old woman suffered from nasal obstruction, postnasal dripping, and hyposmia for 2 months.
Rhinoscopic examination revealed a huge polypoid mass in the right inferior and anterior nasal fossa of the nasal cavity and the mass was resected.
The tumor showed the classic acinar and trabecular features of ACC on light microscopic examination. The finely granular cytoplasmic granules stained with periodic acid-schiff (PAS) and diastase digested-PAS, but not with alcian blue at pH 2.5 and mucicarmine. On ultrastructural examination, tumor cells contained numerous secretory granules diagnostic of ACC.
Juvenile xanthogranuloma (JXG) is a benign and self-limiting non-Langerhans-cell histiocytosis that generally occurs during infancy and childhood. It develops frequently in the head and neck but is very rare in the nasal cavity. To date, only five cases of JXG in the nasal cavity have been reported. Here, we report the second case of JXG in the nasal cavity in Korea. A 19-year-old male patient presented with a protruding 1.1 cm mass in the left nasal vestibule.
Histologically, a dense dermal infiltrate of histiocytes with Touton giant cells was observed. Immunohistochemically, the histiocytes tested positive for CD68 and the S-100 protein but negative for CD1a. This shows that a S-100-positive histiocytic lesion dose not exclude a diagnosis of JXG.
Nasal angiomyolipomas are exceedingly rare and usually present as small tumors in middle-aged or old men. Their histology is similar to that of the renal counterpart, but they differ in the absence of epithelioid cells, the lack of HMB-45 immunoexpression and no association with tuberous sclerosis. A case of angiomyolipoma occurring in the right nasal cavity was presented in a 44-year-old male patient.
The mass was removed by an endoscopic approach. A well-circumscribed, 1.3 cm-sized, ovoid mass was composed of yellowish gray, solid, soft tissue. Histologically, it consisted of bundles of smooth muscles, mature fat cells and thick-walled blood vessels. Nests of seromucous glands were admixed within the mass. Neither epithelioid nor pleomorphic cells were found, and HMB-45-positive cells were not detected. No recurrence has been detected for 2 months after the operation.
Angioleiomyoma of the sinonasal area is an extremely rare benign neoplasm. To the best of our knowledge, only 26 cases have been described. Here, we report a case of angioleiomyoma arising in the nasal cavity of a 60-year-old woman. Microscopically, the tumor consisted of proliferating smooth muscle cells punctuated with thick-walled vessels with slit-like lumina. The tumor was negative for estrogen and progesterone receptor by immunohistochemical study.
Further studies are needed to clarify whether the growth of this tumor is sex steroid-dependent.
Primary extracranial and extraspinal meningiomas are rare. Case s involving the orbit, skin, nasal cavity, paranasal sinuses, oral cavity and parotid gland have been reported.
The histogenesis of primary extracranial meningioma is still nucertain, but it has been thought that this tumor originates from arachnoid cell rests in displaced during embryonal development. The authors observed a case of primary meningioma of the nasal cavity and paranasal sinuses occurring in a thirty-eight year old male patient in Feb.
1989. He suffered from bulging in the medio-superior portion of left orbit for 15 years, and left nasal obstruction and headache for 5 years, A head CT scan revealed numberous polypoid masses filling the left frontal sinus left ethmoidal sinus, left maxillary sinus and left nasal cavity.
During the operation, a connection to the dura was not found. Microscopically, there were discrete lobules or netst of meningothelial cells, beneath the nasal mucosa. They showed an occasional whorling pattern and psammoma bodies.
Therefore, this case was diagnosed as primary meningioma, meningotheliomatous type involving the left nasal cavity and paranasal sinuses.