Figure 1. Intraoperatory view of the mass. DOI http://dx.doi.org/10.13070/rs.en.1.1016 Date 2014-09-10 Cite as Research 2014;1:1016 License CC-BY Benign fibrous histiocytoma of the nasal vestibule: report of a case and review of literature Ioannis Mylonakis1, 2 (ioannis dot mylonakis at unipd dot it) #, Enzo Emanuelli3, Barbara Pedruzzi1, 3, Filippo Marino4, Alessandro Martini1, 3 1 Department of Neurosciences, Univerity of Padua, Italy. 2 ENT Clinic, University Hospital of Padova, Italy. 3 Endoscopic Airways Surgery Unit, University Hospital of Padova, Italy. 4 Anatomical Pathology Unit, University Hospital of Padova, Italy # : corresponding author Benign fibrous histiocytoma (BFH) is a rare connective tissue tumor arising in skin (dermatofibroma), soft tissues and bone (“deep” fibrous histiocytoma). Few cases of soft tissue BFH have been reported in the head and neck and localizations in the nasal fossa are extremely rare. We report the presence of a soft tissue BFH in the right nasal vestibule of a 54 year old male, the first well defined report in the English literature of a tumor of this kind in this particular site. Introduction Benign benign fibrous histiocytoma (BFH) was first described as a separate clinical entity in the 1960s after a lengthy process aiming towards a precise identification of fibrohistiocytic lesions and the distinction between benign and malignant variants [1]. It is now considered a benign mesenchymal lesion composed of fibroblasts and histiocytes arising in the cutaneous and non-cutaneous soft tissues, although disputes still exist on whether this is a true tumor or a reactive mass at least as for the cutaneous form [2] [3]. Confusion on the nature of fibrohistiocytic lesions also accounts for the variety of names used to describe this tumor and its variants: Dermatofibroma, sclerosing hemangioma, adult xanthogranuloma, fibroxanthoma, and nodular subepidermal fibrosis are some of the terms more commonly used in the past to identify this tumors [1]. While cutaneous BFH (dermatofibroma) usually originates in sun-exposed skin, non-cutaneous soft tissue BFH usually presents itself in subcutaneous tissues of the extremities and more rarely in visceral spaces like the retroperitoneum and pelvis; localizations in tendons are rare and visceral presentations anecdotal [3]. The “deep” soft tissue variant of the tumor seems to be relatively more frequent in young children, especially in the head and neck region [4]. BFH arising in the orbital tissues represents the most frequent primary mesenchymal tumor of the orbit in adult patients and accounts for most of the head and neck localizations that would otherwise be rare [5]. In the ENT practice BFH has been more commonly encountered in the bone and soft tissues of the oral cavity such as in the tongue, gingival or alveolar ridge, mandible, maxilla, lips, soft palate, and floor of the mouth. The nasal cavity and paranasal sinuses, larynx, trachea, temporomandibular joint, and submandibular and parotid glands are more rarely involved [5]. A malignant subtype of fibrous histiocytoma has also been described [2] [3]. Tumors of the nasal vestibule are generally rare and reports of nonepithelial variants absolutely exceptional [6] ; no definite cases of fibrohistiocytic tumors in this site are present in literature so far. Case report In February 2012 a 54 year old Italian male presented in the outpatient ambulatory of the Endoscopic Upper Airways Surgery Unit of the University Hospital of Padua with a large, nontender mass of the right nasal vestibule which he had noticed 3 months earlier and had rapidly grown in size since then. The tumor caused local discomfort and unilateral nasal obstruction. The patient referred no specific personal or professional risk factors for nasal disease apart from persistent nasal picking. In his general history there were no other significant pathologies apart from hypertension under treatment with vasodilators. On direct examination the lesion appeared as a pedunculated mass without alterations of the overlying mucosal lining, originating from the alar region of the right nostril (Fig. 1). Complete upper aerodigestive tract endoscopic examination revealed no other lesions. Topics paranasal sinus neoplasms benign fibrous histiocytoma histiocytes
Meningiomas are the most common central nervous system tumor and can be found anywhere in the neuraxis. In rare cases, they may extend beyond the cranial vault, while cases without evidence of intracranial mass existence have also been reported. Here, we report the case of a 64-year-old male patient with a history of craniectomy for parasagittal meningioma, who presented at the emergency department with onset of focal seizures. The patient underwent nonenhanced brain computed tomography scan which was indicative of recurrence of the mass. The patient was scheduled for craniotomy and excision of the mass. He also expressed his desire to have a scalp nodule removed concomitantly. Thickening of the meninges underlying the nodule was observed but without indication of a space-occupying lesion. Both histological examinations were suggestive of Grade II, atypical meningiomas. A case of a subcutaneous meningioma in a patient with a history of surgically excised parasagittal meningioma is presented. Radiologic evidence of dural proliferation underlying the mass was suggestive of an en plaque meningioma secondary to iatrogenic dissemination of tumor cells.
Introduction. Arachnoid cysts are benign lesions comprising about 1 % of all intracranial space occupying lesions. The majority are asymptomatic, while surgical intervention, consisting of fenestration, is suggested in the presence of mass phenomena. The aim of the study – to present the case of a patient with arachnoid cysts in the cerebellopontine angle and its treatment. Materials and methods. A 53‑years old female patient was referred to our Department of Neurosurgery for the surgical management of a cerebellopontine angle mass. The patient reported tingling sensation and causalgia of her left hemiface, dysarthria, hoarseness, difficulty swallowing solid food and liquids, tinnitus and pain distributed along the ophthalmic branch of the trigeminal nerve. Results. The patient was subjected to retrosigmoid craniotomy with fenestration of the cyst and concurrent placement of a Torkildsen shunt. No complete resection of the capsule of the cyst was attempted, due to its tight adhesions to the adjacent structures. Postoperatively, there was an improvement in the dysarthria and swallowing of the patient. Conclusions. Cerebellopontine angle cystic lesions while histologically benign, may become clinically apparent due to compression of adjacent structures. Simple fenestration of the cyst may be sufficient for the remission of symptoms.
Deafness, with its personal and social burden, has certainly accompanied mankind since the beginning of its existence, meaning that various natural aids to hearing, the cupped human hand the first among them, have assuredly been in use since antiquity. Ear trumpets were essentially the first totally artificial type of hearing aid. The actual history of ear trumpets seems to have begun in the seventeenth century, when written evidence on the matter first appears. The French Jesuit Jean Leurechon, in his Recreation Mathematique of 1624, first mentions funnel-like objects as sound amplifiers, while Sir Francis Bacon, in his Sylva Sylvarum, published in 1627, clearly states that similar objects were already in use as aids to hearing. Giovanni Battista della Porta, in his oft-cited Magiae Naturalis of 1589, offers only a vague and inconclusive description of an aid that would once again imitate natural shell forms and can only be considered as one of the first published references to sound amplification. This work focuses on the contribution of Galileo’s disciple Paolo Aproino who, around 1612–13, presented to Galileo, and through this latter to the court of the Grand duke of Tuscany, an auditory instrument that amplified sound, together with his pioneering experimental studies in the field. Using the experimental method taught by Galileo, Aproino was able to test various forms and materials, deciding upon the final design of the instrument that he then supplied to Galileo in order to construct a metal prototype. This trumpet-like linear ear horn seemed to obtain good results in sound amplification, even though it entailed a certain amount of sound distortion that somewhat reduced the intelligibility of speech. Although Aproino never produced any publications on the matter, his findings became known and impressed the scientific and literary milieu of his time and could therefore have been the initial spur for the future development of sound amplification in the following years.
