RESUMO
OBJECTIVES: Exophytic Sinonasal Papilloma (ESP) is a benign tumor of the sinonasal tract. Complete surgical excision by endoscopic surgery is the treatment of choice. However, a high recurrence rate (36% at 5-year follow-up) is associated with this method, which may indicate the presence of microorganisms such as Human Papillomavirus (HPV). It is important to note that the standard treatment for ESP does not include antiviral drugs. In our study, we are testing the effectiveness of an interferon-containing drug in reducing recurrence and postoperative reactions in patients with ESP. METHODS: We included 78 patients aged 23-83 years with a confirmed diagnosis of ESP by rhinoscopy and nasal endoscopy and a positive PCR test for HPV in nasal scrapings. To compare the results, we divided the patients into main and control groups. The main group received recombinant human interferon after surgery, while the control group did not receive the drug. We performed a statistical analysis to compare the proportion of patients without reactive manifestations at different stages of the postoperative period, as well as to compare the proportion of patients with recurrent ESP at certain stages of observation. RESULTS: The introduction of recombinant human interferon accelerated the resolution of postoperative reactions and promoted the healing of the nasal mucosa after surgical removal of the ESP. We also found a statistically significant association between treatment with recombinant interferon and a reduction in the recurrence rate of ESP. CONCLUSION: According to the results of the study, it was found that in the main group of patients who received rhIFN-α2b (recombinant human Interferon alpha 2b) in the postoperative period, the frequency of relapses of ESP and the time of postoperative recovery were significantly lower than in patients in the control group who did not take the drug. LEVEL OF EVIDENCE: Cohort Study.
Assuntos
Interferon alfa-2 , Interferon-alfa , Papiloma , Infecções por Papillomavirus , Humanos , Pessoa de Meia-Idade , Adulto , Idoso , Masculino , Feminino , Interferon alfa-2/uso terapêutico , Infecções por Papillomavirus/tratamento farmacológico , Idoso de 80 Anos ou mais , Adulto Jovem , Interferon-alfa/uso terapêutico , Resultado do Tratamento , Papiloma/tratamento farmacológico , Papiloma/cirurgia , Papiloma/virologia , Neoplasias Nasais/cirurgia , Neoplasias Nasais/tratamento farmacológico , Neoplasias Nasais/virologia , Proteínas Recombinantes/uso terapêutico , Recidiva Local de Neoplasia , Antivirais/uso terapêuticoAssuntos
Estesioneuroblastoma Olfatório/tratamento farmacológico , Indazóis/uso terapêutico , Cavidade Nasal , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Nasais/tratamento farmacológico , Pirimidinas/uso terapêutico , Sulfonamidas/uso terapêutico , Idoso , Estesioneuroblastoma Olfatório/genética , Estesioneuroblastoma Olfatório/secundário , Feminino , Fumarato Hidratase/genética , Humanos , Mutação , Neoplasias Nasais/genética , Neoplasias Nasais/patologia , Indução de Remissão , Retratamento , Fatores de TempoRESUMO
Abstract Infantile hemangioma is the most common pediatric vascular tumor, with the following risk factors: low birth weight, prematurity, white skin, female gender, multiparity and advanced maternal age. The use of oral and topical beta-blockers, although recent, has emerged as the first line of treatment, with superior safety and efficacy to previously used therapies, such as corticosteroids and surgeries. This report describes two cases of nasal tip infantile hemangioma, treated with oral propranolol. Both presented excellent therapeutic responses.
Assuntos
Humanos , Feminino , Lactente , Propranolol/administração & dosagem , Neoplasias Nasais/tratamento farmacológico , Antagonistas Adrenérgicos beta/administração & dosagem , Hemangioma/tratamento farmacológico , Neoplasias Nasais/patologia , Administração Oral , Resultado do Tratamento , Hemangioma/patologiaRESUMO
Infantile hemangioma is the most common pediatric vascular tumor, with the following risk factors: low birth weight, prematurity, white skin, female gender, multiparity and advanced maternal age. The use of oral and topical beta-blockers, although recent, has emerged as the first line of treatment, with superior safety and efficacy to previously used therapies, such as corticosteroids and surgeries. This report describes two cases of nasal tip infantile hemangioma, treated with oral propranolol. Both presented excellent therapeutic responses.
Assuntos
Antagonistas Adrenérgicos beta/administração & dosagem , Hemangioma/tratamento farmacológico , Neoplasias Nasais/tratamento farmacológico , Propranolol/administração & dosagem , Administração Oral , Feminino , Hemangioma/patologia , Humanos , Lactente , Neoplasias Nasais/patologia , Resultado do TratamentoRESUMO
Nasal type extranodal NK/T-cell lymphoma is a distinct entity according to the World Health Organization classification. Although 60% to 90% of patients with this disease present with a destructive mass in the midline facial tissues, it may also primarily or secondarily involve extranasal sites, like the skin. We report the case of a 77-year-old patient that came to our department with erythematous plaques of the right leg and eczematous lesions of the trunk. These lesions were biopsied and the patient was diagnosed with extranodal NK/T-cell lymphoma, nasal type. He was treated with multi-agent systemic chemotherapy but died 5 months after diagnosis. This case highlights the rarity and variability of cutaneous features of this disease and its aggressive course and poor prognosis.
Assuntos
Linfoma Extranodal de Células T-NK/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Nasais/patologia , Neoplasias Cutâneas/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Evolução Fatal , Humanos , Linfoma Extranodal de Células T-NK/tratamento farmacológico , Masculino , Neoplasias Primárias Múltiplas/tratamento farmacológico , Neoplasias Nasais/tratamento farmacológico , Prednisona/uso terapêutico , Pele/patologia , Neoplasias Cutâneas/tratamento farmacológico , Vincristina/uso terapêuticoRESUMO
Abstract Nasal type extranodal NK/T-cell lymphoma is a distinct entity according to the World Health Organization classification. Although 60% to 90% of patients with this disease present with a destructive mass in the midline facial tissues, it may also primarily or secondarily involve extranasal sites, like the skin. We report the case of a 77-year-old patient that came to our department with erythematous plaques of the right leg and eczematous lesions of the trunk. These lesions were biopsied and the patient was diagnosed with extranodal NK/T-cell lymphoma, nasal type. He was treated with multi-agent systemic chemotherapy but died 5 months after diagnosis. This case highlights the rarity and variability of cutaneous features of this disease and its aggressive course and poor prognosis.
Assuntos
Humanos , Masculino , Idoso , Neoplasias Cutâneas/patologia , Neoplasias Nasais/patologia , Linfoma Extranodal de Células T-NK/patologia , Neoplasias Primárias Múltiplas/patologia , Pele/patologia , Neoplasias Cutâneas/tratamento farmacológico , Vincristina/uso terapêutico , Biópsia , Prednisona/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doxorrubicina/uso terapêutico , Neoplasias Nasais/tratamento farmacológico , Evolução Fatal , Ciclofosfamida/uso terapêutico , Linfoma Extranodal de Células T-NK/tratamento farmacológico , Neoplasias Primárias Múltiplas/tratamento farmacológicoRESUMO
Background: Feline nasal lymphoma is generally a localized and radiosensitive tumor. Treatment options include radiation therapy, chemotherapy, or a combination of both treatments. Chemotherapy alone is generally not effective, leading to median survival times of 98 to 358 days, while RT alone or a combination of RT and chemotherapy lead to median survivals of 19 months and 955 days, respectively. Orthovoltage radiation therapy, the only radiation available in Brasil, has the disadvantage of being superficial, treating only tumors of 2 cm or less and causing marked skin side effects. The objective of this paper is to report two cases of advanced feline nasal lymphoma, with cribriform plate destruction and central nervous system invasion, successfully treated with orthovoltage radiation therapy and systemic chemotherapy. Case: Two female mixed breed cats were presented with nasal discharge, sneezing and facial deformity. The second cat also had neurologic signalment. Definitive diagnosis in histopathology was lymphoma. Computed tomography revealed advanced disease in both cases, with intranasal mass, bone lysis, invasion of orbital space and central nervous system. Both cats were treated with radiation therapy combined with chemotherapy. The first case received radiation therapy for gross disease (12 daily fractions of 300 cGy, five times per week) and CCNU/prednisolone [...](AU)
Assuntos
Animais , Gatos , Linfoma/radioterapia , Linfoma/veterinária , Linfoma/tratamento farmacológico , Osso Etmoide , Neoplasias Nasais/tratamento farmacológico , Neoplasias Nasais/radioterapia , Neoplasias Nasais/veterinária , SobrevidaRESUMO
Background: Feline nasal lymphoma is generally a localized and radiosensitive tumor. Treatment options include radiation therapy, chemotherapy, or a combination of both treatments. Chemotherapy alone is generally not effective, leading to median survival times of 98 to 358 days, while RT alone or a combination of RT and chemotherapy lead to median survivals of 19 months and 955 days, respectively. Orthovoltage radiation therapy, the only radiation available in Brasil, has the disadvantage of being superficial, treating only tumors of 2 cm or less and causing marked skin side effects. The objective of this paper is to report two cases of advanced feline nasal lymphoma, with cribriform plate destruction and central nervous system invasion, successfully treated with orthovoltage radiation therapy and systemic chemotherapy. Case: Two female mixed breed cats were presented with nasal discharge, sneezing and facial deformity. The second cat also had neurologic signalment. Definitive diagnosis in histopathology was lymphoma. Computed tomography revealed advanced disease in both cases, with intranasal mass, bone lysis, invasion of orbital space and central nervous system. Both cats were treated with radiation therapy combined with chemotherapy. The first case received radiation therapy for gross disease (12 daily fractions of 300 cGy, five times per week) and CCNU/prednisolone [...]
Assuntos
Animais , Gatos , Linfoma/radioterapia , Linfoma/tratamento farmacológico , Linfoma/veterinária , Neoplasias Nasais/radioterapia , Neoplasias Nasais/tratamento farmacológico , Neoplasias Nasais/veterinária , Osso Etmoide , SobrevidaAssuntos
Neoplasias Bucais/patologia , Neoplasias Nasais/patologia , Rabdomiossarcoma Alveolar/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Criança , Irradiação Craniana , Ciclofosfamida/administração & dosagem , Cistos/diagnóstico , Dactinomicina/administração & dosagem , Diagnóstico Diferencial , Feminino , Humanos , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/tratamento farmacológico , Neoplasias Bucais/radioterapia , Mucosa Nasal/patologia , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/tratamento farmacológico , Neoplasias Nasais/radioterapia , Rabdomiossarcoma Alveolar/diagnóstico por imagem , Rabdomiossarcoma Alveolar/tratamento farmacológico , Rabdomiossarcoma Alveolar/radioterapia , Ultrassonografia , Vincristina/administração & dosagemRESUMO
INTRODUCTION: Nasal natural killer (NK) cell lymphoma that showed distant metastases generally showed an poor prognosis. We described a group of patients with these atypical presentation and that were treated with an intensive, short chemotherapy/radiotherapy regimen. METHODS: Sixty-one patients fulfilled the criteria for NK cell lymphoma with distant metastases and all have very poor prognostic factors: high clinical risk, multiple extranodal presentation and bulky disease (tumor mass >10 cm). They were treated with CMED (cyclophosphamide 2000 mg/m(2), iv, day 1, methotrexate 400 mg/m(2), iv, day 1(with leucovorin rescue), etoposide 400 mg/m(2) twice and dexametasone 40 mg daily for 4 days). If complete response (CR) was observed, they were received adjuvant radiotherapy (50 Gy) to nasal region. Patients with failure were treated with different salvage treatments. RESULTS: Forty nine patients achieved CR and 12 were considered failure, all patients that were failure and nine that relapse die secondary to tumor progression. Median follow-up were 46 months (range 34-68 months). Median has not been observed in relapse-free survival (RFS) and overall survival (OS). Actuarial curves at 5 years showed that RFS was 81% and OS was 65%. Treatment was well tolerated. CONCLUSIONS: Nasal NK cell lymphoma with distant metastases is considered an rare clinical entity, probably is under diagnosis because it has been included as stage III and IV in previous reports, that showed an very poor RFS and OS. The treatment herein report could achieve good response and outcome, but it is evident that more specific and aggressive therapy is necessary in these setting of patients.