Argyrios Manganaris

Oncocytic papillary cystadenoma is a rare, benign tumor highly uncommon in the larynx. Although controversy exists regarding its true nature it is considered a phenomenon of metaplasia. We present the case of a 57-year-old patient with synchronous, bilateral oncocytic papillary cystadenoma of the ventricles and we discuss the current literature.

We present a case of a 79-year-old male patient, who was diagnosed with a primary squamous cell carcinoma of the left parotid region that was fungating through the skin and infiltrating the sternocleidomastoid muscle. Clinically and radiologically, the patient was staged as T3 N2b M0. He underwent a near-total parotidectomy with facial nerve preservation in conjunction with a modified radical neck dissection and wide excision of the involved skin to remove all the disease in a monobloc fashion. A regional cutaneous flap, the anterior cervical flap was used for reconstruction of a large surgical defect.

Glandular tumours constitute a very small percentage of all neoplastic lesions in the nasal cavity. Only a very limited number of cases of acinic cell carcinoma (ACC) involving the nose have been sporadically reported throughout the medical literature. The clinical significance of this case report is due to its unique site. To our knowledge this report represents the only documentation of acinic cell carcinoma arising in the nasal vestibule. Unusual presentations of uncommon malignancies can pose considerable diagnostic dilemmas to both the surgeon and histopathologist. Awareness of these rarities is important to ensure the best patient care.

Case report from JAMA Otolaryngology–Head & Neck Surgery — Pathology Quiz Case 1

We report an exceptional presentation of extramedullary plasmacytoma of the nasopharynx without bone marrow involvement or other characteristics of multiple myeloma. Case report and a review of the world literature concerning the clinical presentation, histopathological features, optimal treatment and prognosis of nasopharyngeal extramedullary plasmacytoma. Reports of patients with symptomatic extramedullary plasmacytomas of the nasopharynx eventually being documented with histopathological evidence are not uncommon; however, the converse appears to be an extremely rare event. The patient was completely asymptomatic and following a paroxysm of coughing, expectorated a polypoidal nodule, which on histopathological investigation had features suggestive of extramedullary plasmacytoma. Although these tumours commonly present with significant nasal symptoms, this exceptional presentation in an asymptomatic patient has never been previously reported. Unusual presentations of rare tumours can pose considerable diagnostic dilemmas to both the surgeon and histopathologist. Awareness of these rarities is important to ensure the best patient care.

Sub-specialty training in otorhinolaryngology and head and neck surgery (ORL-HNS) is not standardised across European Union (EU) states and remains diverse. The objective of this study was to assess the current status of sub-specialty training programmes in head and neck surgical oncology within the European Union (EU-15). A postal questionnaire was distributed to 41 representative members of the European Federation of Otorhinolaryngological Societies (EUFOS) in the specialty of ORL-HNS in 15 EU states. The questionnaire included questions regarding the sub-specialty practice, structure, length, access, examination procedures and certification, future developments and also a space for individual comments. Thirty-one respondents (75.6%) from major training centres in 15 different European countries replied. Overall, the data revealed major diversity for all aspects analysed, between and within the different European countries. Only four EU states had formal sub-specialty training in head and neck surgical oncology. This includes Finland, Germany, The Netherlands, and the United Kingdom. In the rest of EU states, the last year of residency programmes is often spent as an introduction to one of the sub-specialties. Sub-specialty training in head and neck surgical oncology within the EU at present is clearly underdeveloped. Issuing a European diploma in ORL-HNS could be an initial step towards assessing the skills acquired during specialist training within the different European countries and formalising specialist training. This would establish a uniform measure for evaluating candidacy for sub-specialty training both across the EU and for USA, Canada or Australia.

The synchronous occurrence of two histologically different and morphologically distinct tumours in a single parotid gland is an exceptionally rare and probably coincidental event. We have recently experienced such a case initially suspected of being a recurrent pleomorphic adenoma. Superficial parotidectomy, however, revealed two separate masses. Postoperative histopathological examination diagnosed the presence of a pleomorphic adenoma with a concurrent primary parotid gland Hodgkin's lymphoma arising from an intraglandular lymph node. The management of this case is presented along with a brief review of the literature concerning the evaluation and management of this rare entity.