Adult ; Female ; Humans ; Nasal Mucosa ; pathology ; Nose Neoplasms ; diagnosis ; surgery ; Papilloma ; diagnosis ; surgery

Objective:To investigate the effectiveness of nasal endoscopic anterior lacrimal recess approach combined with temporary fenestration of the nasal septum in resecting recurrent nasal inverted papilloma. Methods:Patients with recurrent nasal inverted papilloma who underwent reoperation in our hospital during the past 2 years were included . The nasal septum may hinder full access to and effective treatment of the lesions at the anterior and medial wall of the maxillary sinus by endoscope, aspirator and surgical instrument in the narrow aperture of the prelacrimal recess, although these lesions could be observed by 70° nasal endoscope. Results:The nasal septum is temporarily opened on the basis of the prelacrimal recess approach, and the nasal endoscope and instrument was introduced through trans-septal window, so as to provide a better view of the operative field and the angular range of the instrument's movement. Conclusion:The recurrent nasal inverted papilloma could be successfully managed by re-endoscopic anterior lacrimal recess approach combined with temporary fenestration of the nasal septum, and no recurrence was observed during the 2-year follow-up. This surgical approach is recommended for the inverted papilla which originates from the anterior medial wall of the maxillary sinus, as the tumor can be removed completely using this surgical approach.
Humans ; Papilloma, Inverted/pathology* ; Endoscopy ; Maxillary Sinus/pathology* ; Lacrimal Apparatus/surgery* ; Treatment Outcome ; Retrospective Studies

OBJECTIVE: We wanted to assess the need for surgical excising papillary lesions of the breast that were diagnosed upon sonographically guided 14-gauge core needle biopsy. MATERIALS AND METHODS: Sixty-nine women (age range: 25-74 years, mean age: 51.7 years) with 69 papillary lesions (4.9%) were diagnosed and followed after performing sonographically guided 14-gauge core needle biopsies. Surgical excision was performed for 44 (64%) of 69 papillary lesions, and 25 lesions were followed with imaging studies (range: 6-46 months, mean: 17.9 months). The histologic findings upon core biopsy were compared with the surgical, imaging and follow-up findings. RESULTS: Core needle biopsies of 69 lesions yielded tissue that was classified as benign for 43 lesions, atypical for 18 lesions and malignant for eight lesions. Of the 43 lesions that yielded benign papilloma upon core needle biopsy, one had intraductal papillary carcinoma found upon surgery. An immediate surgical biopsy was recommended for this lesion because of the imaging-histologic discordance. No additional carcinoma was found during the imaging follow-up. Surgical excision was performed for 17 atypical papillary lesions, and this revealed intraductal (n = 6) or invasive (n = 2) papillary carcinoma in 8 (47%) lesions. Of the seven intraductal papillary carcinomas, surgery revealed invasive papillary carcinoma in one (14%). CONCLUSION: Our results suggest that papillary lesions of the breast that are diagnosed as benign upon sonographically guided 14-gauge core needle biopsy can be followed when the results are concordant with the imaging findings.
Adult ; Aged ; Biopsy, Fine-Needle ; Breast/*pathology/surgery ; Breast Neoplasms/*pathology/surgery ; Carcinoma/pathology/surgery ; Female ; Humans ; Middle Aged ; Papilloma, Intraductal/*pathology/surgery ; Retrospective Studies ; *Ultrasonography, Interventional

PURPOSE: We evaluated the characteristics of and treatment outcomes in patients with benign tracheobronchial tumors. MATERIALS AND METHODS: We reviewed the records of patients with benign tracheobronchial tumors who underwent bronchoscopic intervention with mechanical removal and Nd: YAG laser cauterization, and evaluated the characteristics and treatment outcomes of 55 patients with hamartomas, leiomyomas, papillomas, typical carcinoids, or schwannomas seen between April 1999 and July 2012. RESULTS: The most common tumors were hamartoma (n=24), leiomyoma (n=16), papilloma (n=7), typical carcinoid (n=5), and schwannoma (n=3). Forty-one patients (75%) had symptoms. On chest computed tomography, 35 patients (64%) had round or ovoid lesions, accompanied by atelectasis (n=26, 47%) or obstructive pneumonia (n=17, 31%). Fatty components (n=9, 16%) and calcifications (n=7, 13%) were observed only in hamartomas, leiomyomas, and typical carcinoids. At bronchoscopy, the typical findings were categorized according to tumor shape, surface, color, and visible vessels. Fifty (91%) patients underwent complete resection. Forty patients (73%) achieved successful bronchoscopic removal defined as complete resection without complications or recurrence. Recurrences occurred in four papillomas, one leiomyoma, and one typical carcinoid. The proportions of tumor types (p=0.029) differed between the successful and unsuccessful removal groups, and a pedunculated base (p<0.001) and no spontaneous bleeding (p=0.037) were more frequent in the successful removal group. CONCLUSION: We described clinical, radiological, and typical bronchoscopic findings in patients with benign tracheobronchial tumors; these findings might help to differentiate such tumors. Bronchoscopic intervention was a useful treatment modality, and tumor type, pedunculated base, and vascularity may influence successful tumor removal.
Adolescent ; Adult ; Aged ; Bronchi/pathology/*surgery ; Bronchoscopy ; Carcinoid Tumor/pathology/surgery ; Female ; Hamartoma/pathology/surgery ; Humans ; Leiomyoma/pathology/surgery ; Male ; Middle Aged ; Neurilemmoma/pathology/surgery ; Papilloma/pathology/surgery ; Young Adult

OBJECTIVETo investigate malignant transformation of sinonasal inverted papilloma (SIP) treated by nasal endoscopic and endoscopy-assisted surgery.

METHODSSeven cases with malignant transformation of SIP treated by nasal endoscopic and endoscopy-assisted surgery from February 2001 to December 2010 were reviewed. Followed-up time after surgery for each case was over 3 years. All cases were unilateral disease and at grade IV according to the SIP grading standards of Krouse. One case was T2, five T3, and one T4. The surgery were performed under general anaesthesia or local and strengthen anaesthesia. Postoperative radiotherapy was applied, with the doses of 60 - 70 GY.

RESULTSAll cases were squamous cell carcinoma confirmed pathologically after surgery. The patients were followed up with endoscopic examination for 3 - 5 years. Of 7 cases, recurrent disease occurred in 3 years after operation, but no recurrence in other 4 cases.

CONCLUSIONSNasal endoscopic and endoscopy-assisted surgery can be used in the treatment for the malignant transformation of SIP, with the advantages of minimally invasion, fewer complications and the well-preserved nasal functions. Application of radiotherapy after surgery could improve long-term survival efficacy of the patients.

Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; pathology ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Papilloma, Inverted ; pathology ; surgery ; Paranasal Sinus Neoplasms ; pathology ; surgery

Sinonasal inverted papilloma (SNIP) is one of the most common benign sinonasal tumors demonstrating a high recurrence rate after surgery, and sometimes presents malignant tendency or coexists squamous cell carcinoma. Therefore, it is essential to achieve complete surgical resection, especially the original location of SNIP. In this paper, we evaluated the predictability of preoperative CT and magnetic resonance imaging (MRI) for localization of SNIP origin.
Carcinoma, Squamous Cell ; diagnosis ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Nose Neoplasms ; diagnosis ; pathology ; surgery ; Papilloma, Inverted ; Paranasal Sinus Neoplasms ; diagnosis ; pathology ; surgery ; Prognosis ; Tomography, X-Ray Computed

OBJECTIVE: To investigate the application of endoscopic nasal lateral wall dissection in lesions of the maxillary sinus. METHOD: Ten hospitalized patients with the maxillary sinus lesions were treated with the endoscopic nasal lateral wall dissection. RESULT: All 10 patients were unilateral invasion. Among them, 7 cases were inverted papilloma, 2 cases were recurrent antrochoanal polyps, 1 case was sinusal tooth. The tumors and antrochoanal polyps originated from the every part of the maxillary sinus wall during operation, especially from the anterior and media wall. During 10-62 months follow-up,epithelization of nasal occured and the shape of inferior turbinate was well. All of them had no epiphora. CONCLUSION Endoscopic nasal lateral wall dissection can remain the function of nasal lacrimal duct and nasal cavity,and may provide a new minimally invasive approach for complete resection of lesions of nasal cavity and the maxillary sinus.
Dissection ; Endoscopy ; Humans ; Lacrimal Apparatus ; Maxillary Sinus ; pathology ; Nasal Cavity ; Nasal Polyps ; surgery ; Papilloma, Inverted ; surgery ; Turbinates

Breast cancer developing from a surgical scar is rare; this type of malignancy has been reported in only 12 cases to date. Herein, we report on a 52-year-old female who developed infiltrating ductal carcinoma in a surgical scar following excision of a benign mass. Two years previously, the patient underwent surgery and radiotherapy for invasive ductal carcinoma of the contralateral breast. The initial appearance of the scar was similar to fat necrosis; it was observed to be progressively shrinking on follow-up sonography. On the two year follow-up ultrasound, the appearance changed, an angular margin and vascularity at the periphery of the scar were noted. A biopsy and subsequent excision of the scar were performed; the diagnosis of infiltrating ductal carcinoma of the scar was confirmed.
Breast Neoplasms/*etiology/pathology/surgery ; Carcinoma, Ductal, Breast/*etiology ; Cicatrix/*complications ; Female ; Foreign-Body Reaction/pathology ; Giant Cells/pathology ; Humans ; Middle Aged ; Papilloma, Intraductal/pathology/surgery

Aged ; Breast Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Mastectomy ; methods ; Metaplasia ; pathology ; Papilloma, Intraductal ; pathology ; surgery ; Sebaceous Glands ; pathology

Adenoma, Villous ; metabolism ; pathology ; surgery ; Aged ; Diagnosis, Differential ; Female ; Humans ; Keratin-20 ; metabolism ; Keratin-7 ; metabolism ; Mullerian Ducts ; pathology ; Papilloma ; pathology ; Vaginal Neoplasms ; metabolism ; pathology ; surgery