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Shi Y, Xie M, Zhang QQ, Guo RX, Qiang Y, Yang HN, Liu XH, Luo HN. The subglottic involvement is an independent risk factor for recurrence of laryngeal amyloidosis. Eur Arch Otorhinolaryngol 2023; 280:5003-5009. [PMID: 37515635 DOI: 10.1007/s00405-023-08150-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/24/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To analyze the risk factors for recurrence of laryngeal amyloidosis (LA). METHODS The clinical data of patients with LA admitted in the Otolaryngology Head and Neck Surgery Department of the Second Affiliated Hospital of Xi'an Jiaotong University from August 2009 to June 2022 were analyzed retrospectively; then, the risk factors for recurrence and their impacts on the recurrence time were also analyzed. RESULTS Of the 44 patients with LA, the majority (38 cases, 86.4%) only involved one anatomical region and the others (6 cases, 13.6%) involved two laryngeal regions concurrently. Overall, the glottic region was the most commonly affected area (28 cases, 63.6%), followed by the supraglottic region (16 cases, 36.4%) and subglottic region (6 cases, 13.6%). In addition, all the lesions were categorized as isolated nodule (31.8%), submucosal localized deposition (52.3%), and submucosal diffuse deposition (15.9%) according to their morphologies under electronic laryngoscope. Finally, six patients (13.6%) had recurrence after operation with a median recurrence time of 24.5 months, and subglottic involvement was confirmed to be an independent risk factor for recurrence of LA by univariate and multivariate logistic regression analyses (P < 0.05). Meanwhile, the patients with subglottic involvement presented as submucosal diffuse deposition had a considerable shorter recurrence time (t = 5.759, P = 0.005). CONCLUSION The subglottic involvement is an independent risk factor for recurrence of LA. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Yao Shi
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiao Tong University, No. 157 Xi-Wu Road, Xi'an, 710004, Shannxi, China
| | - Meng Xie
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiao Tong University, No. 157 Xi-Wu Road, Xi'an, 710004, Shannxi, China
| | - Qing-Qing Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiao Tong University, No. 157 Xi-Wu Road, Xi'an, 710004, Shannxi, China
| | - Rui-Xin Guo
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiao Tong University, No. 157 Xi-Wu Road, Xi'an, 710004, Shannxi, China
| | - Yin Qiang
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiao Tong University, No. 157 Xi-Wu Road, Xi'an, 710004, Shannxi, China
| | - Hao-Nan Yang
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiao Tong University, No. 157 Xi-Wu Road, Xi'an, 710004, Shannxi, China
| | - Xiao-Hong Liu
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiao Tong University, No. 157 Xi-Wu Road, Xi'an, 710004, Shannxi, China.
| | - Hua-Nan Luo
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiao Tong University, No. 157 Xi-Wu Road, Xi'an, 710004, Shannxi, China.
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Wentland K, Shukairy MK, Picken MM, Patadia MO. Localized Amyloidosis of the Sphenoid Sinus: A Case Report and a Descriptive Literature Review. Cureus 2023; 15:e39039. [PMID: 37323320 PMCID: PMC10266508 DOI: 10.7759/cureus.39039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Amyloidosis is the process of extracellular deposition of protein fibrils and manifests pathologically as a systemic or localized process. Localized amyloidosis of the head and neck is uncommon, and involvement of the sphenoid sinus is exceedingly rare. We describe a case of localized amyloidosis isolated from the sphenoid sinus. A descriptive literature search was conducted to highlight presentation, management, and outcomes related to this pathology. Our patient was a 65-year-old male who presented to our clinic with nasal congestion and an incidental finding of a large expansile mass within the sphenoid sinuses. The mass was seen to displace the pituitary gland, and thus a multidisciplinary care approach ensued. The mass was removed via a transnasal endoscopic approach. Pathology revealed fibrocollagenous tissue with calcifications that were positive on Congo red staining. The patient underwent further workup to rule out systemic involvement, which was unremarkable. Based on the findings of his workup, he was ultimately diagnosed with localized amyloidosis. A comprehensive review of the literature revealed 25 other reported cases of localized amyloidosis within the sinonasal region, with only one other case of isolated sphenoid sinus disease. Common presenting symptoms are nonspecific and may mimic other, more frequently seen regional pathologies, including nasal obstruction, rhinorrhea, and epistaxis. The treatment for localized disease is surgical resection. While localized amyloidosis within the sinonasal region is rare, it is important to recognize, work up, and treat it appropriately. A multidisciplinary team approach is necessary for appropriate diagnosis and management, and these patients should be followed closely after treatment.
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Affiliation(s)
- Kelly Wentland
- Otolaryngology, Loyola University Medical Center, Maywood, USA
| | | | - Maria M Picken
- Pathology, Loyola University Medical Center, Maywood, USA
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Localized laryngeal amyloidosis: A systematic review. Am J Otolaryngol 2022; 43:103550. [DOI: 10.1016/j.amjoto.2022.103550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/24/2022] [Indexed: 11/22/2022]
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Bezerra HKF, de França TRT, Prado JD, Saint-Gerons RS, de Amorim Carvalho EJ, da Cruz Perez DE. Oral localized amyloidosis. Head Neck Pathol 2022; 16:818-822. [PMID: 35296978 PMCID: PMC9424412 DOI: 10.1007/s12105-022-01436-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
This report describes two cases of oral localized amyloidosis (LA). In case 1, a 52-year-old man appeared with painful slightly, yellowish multiple nodules located on the dorsum of the tongue, of unknown duration. Incisional biopsy was performed, and the histopathologic analysis revealed a homogeneous, eosinophilic, and extracellular material. Congo red stain showed salmon pink coloration at light microscopy and apple-green birefringence at polarized light. In case 2, a 74-year-old man presented asymptomatic nodular lesions on the labial commissures with duration of several months. An excisional biopsy was performed in both lesions, and microscopically the specimen demonstrated the same histopathologic features of the case 1. Furthermore, amyloidosis with systemic involvement was excluded after investigations for both patients. Thus, the final diagnosis for both cases was LA. The patient 1 refused the surgical excision of the residual lesion, and in both cases, no signs of clinical and systemic progression were observed after 24 and 84 months of follow up. Although it is rare, LA should be considered in the differential diagnosis of multiple or single yellowish nodules on the oral cavity.
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Affiliation(s)
- Hélen Kaline Farias Bezerra
- Department of Clinical and Preventive Dentistry, Oral Pathology Unit, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - José Divaldo Prado
- Department of Stomatology, A. C. Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - Rafael Segura Saint-Gerons
- Andalusian Healthcare Service, Department of Medical and Surgical Specialties, University of Córdoba, Córdoba, Spain
| | - Elaine Judite de Amorim Carvalho
- Department of Clinical and Preventive Dentistry, Oral Pathology Unit, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Danyel Elias da Cruz Perez
- Department of Clinical and Preventive Dentistry, Oral Pathology Unit, Federal University of Pernambuco, Recife, Pernambuco, Brazil. .,Department of Clinical and Preventive Dentistry, Oral Pathology Unit, Universidade Federal de Pernambuco, 4ª Travessa Professor Artur de Sá, s/n, CEP: 50740-521, Recife, PE, Brazil.
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Takakura H, Tachino H, Takii K, Imura J, Shojaku H. Localized Amyloidosis of the Nasal Mucosa: A Case Report and Review of the Literature. Front Surg 2021; 8:774469. [PMID: 34805263 PMCID: PMC8602088 DOI: 10.3389/fsurg.2021.774469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022] Open
Abstract
Amyloidosis is a disorder of protein folding in which various proteins automatically aggregate into a highly abnormal fibrillar conformation. Amyloidosis is classified into systemic and localized forms depending on whether the abnormal proteins deposited in several different organs or only a single organ. In localized amyloidosis of the head and neck regions, laryngeal amyloidosis is common; however, localized amyloidosis of the nose is extremely rare. We herein report a case of localized amyloidosis of the nose and review the relevant literature on localized sinonasal amyloidosis. A 41-year-old man presented with a history of severe nasal obstruction, which had persisted for two decades. Nasal endoscopy and imaging studies showed extensive thickening of the bilateral nasal mucosa and diffuse submucosal deposition of calcification. After histopathological and systemic examinations, he was diagnosed with localized amyloidosis of the nasal mucosa. Septoplasty and bilateral inferior turbinoplasty, which consisted of mucosal resection using an ultrasonic bone curette, was performed and his symptoms markedly improved. Localized sinonasal amyloidosis has a good prognosis and surgical resection should be selected as a first-line treatment; however, clinicians should recognize the high probability of recurrence.
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Affiliation(s)
- Hiromasa Takakura
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Hirohiko Tachino
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Kouji Takii
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Johji Imura
- Department of Diagnostic Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Hideo Shojaku
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
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