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Inverted papilloma is a rare, benign sinonasal tumor. Its etiology is the most likely related to HPV infection. Inverted papilloma originates from the ciliated respiratory epithelium, typically from the lateral nasal wall. The tumor is characterized by endophytic growth inwards the stroma with adjacent tissues destruction. The clinical symptoms are non-specific, such as: unilateral obstruction of the nasal duct, rhinorrhoea, epistaxis and anosmia. The treatment consists in a complete surgical excision of the tumor. Inverted papilloma has a tendency to recurrence with incomplete resection and a potential to malignant transformation to squamous cell carcinoma. This manuscript presents a case of a young woman who suffered from recurrent epistaxis from ulceration of the mucous of the anterior part of the nasal septum. The patient in the interview had indicated the symptoms since six months and unsuccessful treatment with cetirizine. The woman was qualified to a surgical removal of the lesion with a transnasal approach. The histopahtological examination of the sample revealed Papilloma inversum. One-year follow up did not disclose the recurrence of the tumor.

Squamous cell carcinoma of the external auditory canal is a very rare and unusual malignancy, representing less than 0.2% of all head and neck cancers. The authors present a case of 78-year-old patient with bilateral squamous cell carcinoma of the external auditory canal-cT4N0M0 G2, pT4N2bM0, initially treated as a chronic otitis external. The patient was qualifies for the one-step removal of cancer of the earlobe and the external auditory canal. Because of complications during the operation, the plan of treatment was changed. The patient is under oncological control for 13 months., (© 2015 MEDPRESS.)

Brachial cleft cyst is a congenital anomaly arising from persistent elements of branchial apparatus. It may assume the form of cyst, sinus or fistula and constitutes 30% of all congenital anomalies of the neck region. Brachial cleft cyst is usually recognized in patients before the 5th year of age, but it may appear in patients between 20 and 40, when it enlarges owing to infection. It reveals then as a smooth, resilient tumor in lateral region of the neck. Ultrasonography, computerized tomography and magnetic resonance may be used to evaluate and differentiate these lesions as well as to reveal the presence of fistula, which is important to plan the proper surgical treatment. The only effective treatment is total surgical excision. The lack of treatment puts a patient at risk of infections, while incomplete removal might result in recurrence.

There are reports that hearing loss is one of the clinical manifestations of metabolic bone diseases. Demineralization can lead to a reduction in ossicular mass. Paget's disease can reveal loss of mineral density of the cochlear bone. Ear bone remodeling in osteoporosis is similar to the changes in otosclerosis. Moreover, osteoporosis, osteogenesis imperfecta and otosclerosis have a similar genetic mechanism. According to some researchers osteopenia and osteoporosis may well be associated with idiopathic benign positional vertigo (BPV). Dysfunction of the organ of hearing and balance in patients with renal insufficiency may be due to disturbances in calcium phosphate balance and renal osteodystrophy in the course of the disease. Proving the presence of hearing loss in patients with metabolic bone diseases may lead to determining the new indications for bone densitometry in some patients with hearing impairment. Furthermore, audiological examination in patients with osteoporosis may be important because of the impact of hearing loss on prognosis for patients with metabolic bone diseases.

Tubercular infection is still one of the most serious health and social problems. It's been estimated that one-third of the population is infected with Koch's bacillus. More than 90% of overall morbidity of tuberculosis in Poland pose pulmonary tuberculosis, in the worldwide level the percentage reaches 80. The most popular causes that spread the disease are famine, malnutrition, homelessness, limited availability to medical care, alcohol abuse, drug addiction, ageing of the society and more intensive migration. Among the cases of extrapulmonary tuberculosis the most common were certified as tuberculous empyema. Head and neck tuberculosis is diagnosed rarely nowadays. Its symptoms aren't pathognomonic and natural history of the disease is different from those described in medical books. It is essential to enclose laryngeal carcinosis in differential diagnosis. In 2002 two cases of laryngeal tuberculosis were diagnosed in the Department of Otolaryngology Head and Neck Surgery of Medical University of Wroclaw. Both patients had sustained hoarseness. Biopsy confirmed the diagnose of tuberculosis. Both patients underwent the tuberculostatic treatment. Videolaryngoscopic examination showed complete withdrawal of the infiltration in the larynx.

Ormond's disease (RPF) is chronic inflammatory process characterized by intensive fibrosis and inflammatory cells infiltration in retroperitoneal space. RPF in most cases possess idiopathic origin and is rare in children. The histopathologic verification is needed for establishing a proper diagnosis of disease. In this study a case of RPF in 17-year-old girl was reported which caused many diagnostical and therapeutical difficulties. In our patient streptococcal tonsillitis was recognized as a primary cause of disease.

Unlabelled: CDC25 phosphatases, significant positive regulators of the cell cycle play a pivotal role in controlling cell proliferation during development and tumorigenesis. The prevalence and clinical implications of CDC25 immunoreactivity in laryngeal squamous cell cancer (LSCC) patients however, have not been elucidated., Aim: The object of the study was to assess the relationship between the expression levels of CDC25A, CDC25B and clinicopathological parameters and overall survival time of patients with LSCC., Material and Methods: Tissue blocks from 46 patients treated surgically at our institution between 1992 and 2000 were available for this study. Immunohistochemistry using polyclonal antibodies against CDC25A and CDC25B was used to examine proteins expression. Ki-67 antigen expression was examined as a cell proliferation marker. Control group consisted of 21 samples of unchanged mucosa., Results: CDC25A and CDC25B expression was observed in 96% (44/46) and 56.5% (26/46) of tumors; the mean labeling index was 73.9% and 36.5% respectively. CDC25 phosphatases expression was higher in LSCC compare to the control group (p<0.001). There was not any significant correlation between the levels of CDC25 phosphatases and investigated variables. In univariate analysis, all classical clinicopathological parameters but none of the proteins were related to the overall survival time., Conclusions: The expression of CDC25A, CDC25B and the proliferation marker Ki-67 are not associated with prognosis in LSCC.

Introduction: Adhesion molecules, angiogenesis markers and protein products of suppressor genes are potential prognostic indicators in different type of tumours. The purpose of this study was to analyze relations between expression of these markers and clinical as well as histological features of oral cavity and maxillary sinus tumours., Material and Methods: Measurements of expression of CD44, TP53, Nm23 oncoproteins and angiogenesis markers were performed. Forty-three patients treated in years 1985-2000 in the Department of Maxillofacial Surgery of the University Hospital in Wroclaw entered our study. Thirty-two of them were treated for oral cavity cancers. Remaining eleven patients were treated for maxillary sinus cancers., Results: We have shown, there was a positive correlation between the number of the vessels and presence of the nodal metastases; between histological grading and VCAM expression; between CD44 expression and total surface area of the blood vessels. There was also correlation between total surface area of the blood vessels and patients' survival time.

Unlabelled: Malignant neoplasms of the nose and paranasal sinuses occur rarely but due to late diagnosis and poor treatment effects still remain a serious problem. The aim of the study was the analysis of all nose and paranasal sinus neoplasms treated at Lower Silesia in the years 1992-2001., Material and Methods: In the years 1992-2001 in Lower Silesia region there were 182 patients treated for malignant nose and paranasal sinus tumors. Males outnumbered females significantly with male : female ratio was 1.9:1. Principal management was combined therapy--surgery with radiotherapy in 84% of the cases. Radiotherapy alone was performed in 8.8% and chemotherapy as palliative treatment in 7.1%. Fifteen patients (8.2%) underwent radical neck dissection followed by radiotherapy., Results: The analysed group constituted 79.6% patients with epithelial tumors and 20.4% with nonepithelial tumors. Cases T3-T4 predominated in the material in amount of 77.9% (113). There were 15 T2 cases (10.4%) and none of T1. Most of the tumors (57%) arose from middle segment of ethmomaxillary sinuses. Upper segment tumors constituted 18.6% of cases and lower segment--10.4%. Enlarged lymph nodes were diagnosed in 8.2%. Survival rate analysis in patient treated in the years 1992-2001 revealed 37.9% (69) of 3-year survival and 30.2% (55) of 5-year survival., Conclusions: Unsatisfactory results of treatment are an effect of a high advanced stage of the tumor while diagnosed. Its direct causes are: asymptomatic course of the disease, localization in complex anatomical structure, not enough experience among medical staff dealing with the disease very rarely.

Background: During oncogenesis significant changes in tissue properties occur that result in alteration of fluorescence characteristics of the tissue. The aim of our study was to determine the usefulness of autofluorescence technique in diagnostic of laryngeal epithelium lesions., Material and Methods: 40 patients admitted to the Department of Otolaryngology Wroclaw Medical University due to different laryngeal lesions were included into the study. They underwent white light laryngoscopy followed by autofluorescence videoendoscopy. AF was induced by blue light of xenon short arc lamp and processed by a D-light AF System (Storz). Autofluorescence and white light images were immediately assessed and later compared with to histopathological findings., Results: Normal laryngeal mucosa showed a typical green fluorescence signal. Squamous cell carcinoma displayed a diminished green fluorescence and in some cases presented reddish-yellow color., Conclusions: We revealed that autofluorescence laryngoscopy is very helpful, supplementary tool in diagnosis of laryngeal pathology. Autofluorescence laryngoscopy is noninvasive technique designed especially for diagnostic of early and premalignant lesions.

Unlabelled: Abnormal cellular DNA content, a hallmark of malignancy, is known to be an important prognostic factor in many human solid tumors. In laryngeal tumors studies are not as common as in different locations., The Purpose: Of this study was to analyze the prognostic value of DNA content in squamous cell carcinoma of the larynx and relations between aneuploidy and clinical as well as histological features of the tumor., Materials and Methods: Sixty-two patients with squamous cell carcinoma of the larynx treated in years 1997-2001 on the ENT department of the University Hospital in Wroclaw were subject of our study. Flow cytometric DNA ploidy, S-phase fraction and index DNA measurements were performed on fresh frozen tumor tissues., Results: Results were compared to histological grading and TNM category. There was a positive relation between DNA aneuploidy, histological grading and with lymph node metastases. This correlation did not reach statistical significance. We also noticed low mean values of index DNA in advanced tumors (G3, T4, N+)., Conclusions: The results of this study suggest that presence of aneuploid cells in laryngeal cancer can be related to lymph node metastases and tumor grading. Studies should be continued to prove results on the major number of patients.

Abnormal cellular DNA content, a hallmark of malignancy, is known to be an important prognostic factor in many human solid tumors. The purpose of the following research was to analyze the prognostic value of DNA index in aneuploid squamous cell carcinoma of the larynx and relations between S+G2M phase fraction and clinical as well as histological features of the tumor. Eighty-six patients with squamous cell carcinoma of the larynx treated in years 1997-2002 in the ENT Department of the University Hospital in Wroclaw were subject of our study. Flow cytometric DNA ploidy, S-phase fraction and index DNA measurements were performed on fresh frozen tumor tissues. Results were compared to histological grading and TNM category. We have shown, there is a positive correlation between the histopathological diagnosis and DNA ploidy, between DNA ploidy and S+G2M phase fraction and between the tumor size and S+G2M phase fraction. We noticed a positive correlation between the DNA index of the tumor and presence of the nodal metastases, there was also correlation between the DNA index of the tumor and S+G2M phase fraction.