Primary frontal sinus lymphoma is a very uncommon disease. In all the previously reported cases, the presenting symptoms have been due to the tumor mass effect. We present an unusual case report of an immunocompetent patient who presented with facial palsy, and then progressively developed other cranial nerve palsies over several months. He was later diagnosed with diffuse large B cell lymphoma originating from the frontal sinus. The patient underwent chemotherapy, but eventually had to receive autologous peripheral blood stem cell transplantation. He is currently disease-free. The clinical course, diagnostic workup, and therapeutic outcome are described.
Adult ; Cranial Nerve Diseases/*diagnosis/pathology ; Frontal Sinus/*pathology ; Humans ; Lymphoma/*diagnosis/pathology ; Male

Cranial Fossa, Middle ; pathology ; Cranial Nerve Neoplasms ; diagnosis ; pathology ; Facial Nerve Diseases ; diagnosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; pathology ; Tomography, X-Ray Computed

Adolescent ; Adult ; Child ; Cranial Fossa, Middle ; pathology ; Cranial Fossa, Posterior ; pathology ; Cranial Nerve Neoplasms ; diagnosis ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; pathology ; surgery ; Trigeminal Nerve Diseases ; diagnosis ; pathology ; surgery

A retrospective study of 29 cases of brain-stem gliomas(BSG's) from 1989 to 1993, was performed to determine prognostic factors. Our study also analyzed clinical features, growth patterns, pathologic findings and modalities of treatment in patients with brain-stem gliomas. The patients ranged in age from 6 to 65 years, most commonly in the first decade. The symptom duration prior to diagnosis was 1/2 to 6 months(mean 1 1/2 months). The most common symptom and sign were cranial nerve palsies, especially 6th or 7th cranial nerve. The growth patterns of BSG's were classified into diffuse tumors(7 patients), exophytic(9 patients), focal(2 patients) and cervicomedullary(1 patient). Twenty three of 29 patients were diagnosed pathologically by means of stereotactic biopsy(13 patients) and ope surgery(10 patients). The Pathologic findings were low grade astrocytoma in 9 patients, oligodendroglioma(3 patients), malignant astrocytoma(7 patients), and glioblastoma mulitiforme(4 patients). A significant correlation between diffuse growth pattern and malignant pathologic finding could be obtained(P=0.05). The methods of radiation therapy for BSG's were conventional(10 patients), hyperfractionated(13 patients), and Gamma knife radiosurgery(6 patients). The median survival time was 12 months. The Poor prognostic factors determined in our study were 1) short symptom duration prior to diagnosis(< or = 2 months), 2) diffuse growth pattern, 3) malignant pathologic finding, 4) tumor without cystic portion, and 5) tumor without hydrocephalus.
Astrocytoma ; Cranial Nerve Diseases ; Cranial Nerves ; Diagnosis ; Glioblastoma ; Glioma ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Pathology* ; Prognosis* ; Retrospective Studies

Adult ; Anti-Inflammatory Agents ; therapeutic use ; Atrioventricular Block ; diagnosis ; etiology ; pathology ; Cranial Nerve Diseases ; diagnosis ; etiology ; pathology ; Humans ; Male ; Prednisolone ; therapeutic use ; Sarcoidosis ; complications ; diagnosis ; pathology

Cochlear Nerve ; chemistry ; pathology ; Cranial Nerve Neoplasms ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Heart Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; Neurilemmoma ; metabolism ; pathology ; S100 Proteins ; metabolism ; Vestibulocochlear Nerve Diseases ; metabolism ; pathology ; Vimentin ; metabolism

OBJECTIVE: 10 summarize tne clinical features of the facial nerve tumors involving the internal auditory canal and promote the management of facial nerve tumor. METHOD: We retrospectively reviewed the clinical manifestations, the experiences of diagnosis and treatment of the facial nerve tumor involving the internal auditory canal. All these 5 cases were enrolled during January 2013 to Apr 2015. RESULT: Among the 5 cases, 3 cases were facial neurilemmoma and the others were facial neurofibroma. The main symptoms of facial nerve tumors involving the internal auditory canal most commonly were facial paralysis companied with hearing loss. All the patients accepted the surgical treatment with various approaches, 3 cases of translabyrinthine approach, 1 case of middle fossa approach, and 1 case of combination of translabyrinthine and transotic approach. Total tumor resection were achieved in all 5 cases. Facial-hypoglossal nerve anastomosis was performed in one case, another case was undergone great auricular nerve graft. CONCLUSION Surgical intervention for patients with facial neuroma involving internal auditory canal should be considered when facial weakness has deteriorated to grade 4. The management should be based on the patient's hearing, facial nerve function, tumor size and invasive extension to select the appropriate surgical procedures.
Anastomosis, Surgical ; Cranial Nerve Neoplasms ; diagnosis ; surgery ; Facial Nerve ; pathology ; surgery ; Facial Nerve Diseases ; diagnosis ; surgery ; Facial Paralysis ; complications ; Hearing Loss ; complications ; Humans ; Hypoglossal Nerve ; surgery ; Neurilemmoma ; diagnosis ; Neurofibroma ; diagnosis ; Retrospective Studies

OBJECTIVE: Aimed to analyse the clinical features of the patients with sphenoid sinus mucocele, achieve earlier diagnosis and more timely intervention and decrease the occurrence of misdiagnoses. METHOD: A retrospective study was first conducted in patients with sphenoid sinus mucoele treated in Xiangya hospital from Jan 2000 to Jan 2015. Then literature reports on this disease were collected and analyzed from China National Knowledge Infrastructure (CNKI) and Wan Fang database. RESULT: We collected 82 patients with sphenoid sinus mucocele treated in Xiangya hospital. There were 52 patients presented with headache, 31 patients presented with visual impairment, 10 patients presented with cranial nerve palsy, 2 patients presented with exophthalmos, 15 patients presented with nasal symptoms, and 5 patients with no obvious symptoms. There was no significant difference for symptoms distribution between male and female patients (P > 0.05). Among 45 patients with headache as first symptom and 10 patients with ethmoid sinus mucocele, there were 18 patients and 8 patients subsequently suffering from visual impairment, respectively. We also collected 161 patients in literature except for enrolling, the 82 patients treated in Xiangya hospital, and found that headache was the most common symptom, followed by visual impairment, in the two independent cohorts. CONCLUSION To the best of our knowledge, this is the study of maximum sample for sphenoid sinus mucocele in China. Headache and visual impairment are the most common symptoms for sphenoid sinus mucocele. Surgical treatment should be early performed when the desease accompanied with headache or ethmoid sinus mucocele, to avoid other complications such as visual impairment and even blindness.
China ; Cranial Nerve Diseases ; etiology ; Databases, Factual ; Diagnostic Errors ; Ethmoid Sinus ; Exophthalmos ; etiology ; Female ; Headache ; etiology ; Humans ; Male ; Mucocele ; complications ; diagnosis ; pathology ; Paranasal Sinus Diseases ; Retrospective Studies ; Sphenoid Sinus ; pathology ; Vision Disorders ; etiology

Skull base osteomyelitis (SBO) is difficult to diagnose when a patient presents with multiple cranial nerve palsies but no obvious infectious focus. There is no report about SBO with septic pulmonary embolism. A 51-yr-old man presented to our hospital with headache, hoarseness, dysphagia, frequent choking, fever, cough, and sputum production. He was diagnosed of having masked mastoiditis complicated by SBO with multiple cranial nerve palsies, sigmoid sinus thrombosis, and septic pulmonary embolism. We successfully treated him with antibiotics and anticoagulants alone, with no surgical intervention. His neurologic deficits were completely recovered. Decrease of pulmonary nodules and thrombus in the sinus was evident on the follow-up imaging one month later. In selected cases of intracranial complications of SBO and septic pulmonary embolism, secondary to mastoiditis with early response to antibiotic therapy, conservative treatment may be considered and surgical intervention may be withheld.
Anti-Bacterial Agents/therapeutic use ; Anticoagulants/therapeutic use ; C-Reactive Protein/analysis ; Cranial Nerve Diseases/complications/diagnosis ; Diagnosis, Differential ; Enterobacter aerogenes/isolation & purification ; Enterobacteriaceae Infections/diagnosis/drug therapy ; Humans ; Lung/pathology/radiography ; Magnetic Resonance Imaging ; Male ; Mastoiditis/complications/diagnosis ; Middle Aged ; Osteomyelitis/complications/*diagnosis/drug therapy ; Pulmonary Embolism/complications/*diagnosis/microbiology ; Sinus Thrombosis, Intracranial/complications/diagnosis ; Skull Base ; Sputum/microbiology ; Tomography, X-Ray Computed