Onyekwelu O, DeZoysa O, Watts S
The Royal Sussex County Hospital, UK.
J Surg Case Rep. 2012 Oct 1;2012(10):8. doi: 10.1093/jscr/2012.10.8.
We present the first-ever documented evidence of mitotic figures in a case of sinonasal myxoma diagnosed in a 37 year-old gentleman. A 37 year-old gentleman was referred to the Otolaryngology clinic with left nasal discharge for six months. Preoperative images demonstrated obstruction of the left nasal airway with complete opacification of the left maxillary sinus, obscuration of the osteomeatal complex, as well as expansion and thinning of the medial wall of the maxillary antrum. The patient underwent diagnostic Funtional Endoscopic Sinus Surgery (FESS), therapeutic left Caldwell-Luc antrostomy, and revision FESS following recurrence. The patient was symptom-free at routine follow-up post-op. There has been much debate as to whether the absence of mitotic features in a specimen is absolutely necessary in order to confirm the diagnosis. We postulate that the presence of mitoses is an unusual diagnostic feature in extensive sinonasal myxoma.
我们首次记录了在一名37岁男性鼻窦黏液瘤病例中出现有丝分裂象的证据。一名37岁男性因左侧鼻分泌物增多6个月被转诊至耳鼻喉科门诊。术前影像显示左侧鼻道阻塞，左侧上颌窦完全浑浊，骨窦复合体模糊，以及上颌窦内侧壁扩张变薄。患者接受了诊断性功能性鼻内镜鼻窦手术（FESS）、治疗性左侧柯-陆氏上颌窦根治术以及复发后的FESS修正手术。患者术后常规随访时无症状。关于标本中不存在有丝分裂特征是否是确诊的绝对必要条件一直存在很多争论。我们推测有丝分裂的存在是广泛鼻窦黏液瘤中一种不寻常的诊断特征。
