Adult Burkitt lymphoma originating in the sphenoid sinus: case report and review of the literature

Burkitt lymphoma is a high-grade B-cell non-Hodgkin lymphoma. The endemic form of this malignancy occurs primarily in children aged 5 to 7 years, and it presents with jaw and facial bone involvement. The sporadic form affects older children (mean age: 12.2 yr) and often manifests as an abdominal mass; it rarely involves the head and neck. The presence of any type of lymphoma in the paranasal sinuses is rare. We report a case of Burkitt lymphoma that originated in the sphenoid sinus in a 66-year-old white woman. The patient presented with hypoesthesia in the left V1 and V2 distributions and frequent left-sided headaches. Imaging revealed that the destructive lesion had spread into the cavernous sinus and infratemporal fossa. Repeat imaging showed progression of the lesion in just 1 month. An endoscopic sphenoidotomy was performed to obtain a tissue specimen, and a diagnosis of sporadic Burkitt lymphoma was established on the basis of its clinical, morphologic, and immunohistochemical characteristics. The patient underwent chemotherapy and radiation. Short-term follow-up imaging showed that the lesion had disappeared, and the patient remained disease-free at 3 years of follow-up. This case is one of the few reported cases of true adult Burkitt lymphoma originating in the sphenoid sinus. We discuss the rapid progression of the disease and the considerable amount of invasion that can occur with minimal symptoms.

[Prolactinoma of the sphenoid sinus. Case report and literature review]

In this case study, we report on a patient complaining of headache who, after CT and MRI, was found to have a neoplasia of the left sphenoid sinus. After a transnasal biopsy and histological examination, a prolactinoma was diagnosed. Based on this case, we discuss important aspects of tumor biology, diagnostic procedures, histology as well as differential diagnosis. Prolactinoma has to be considered as a differential diagnose in all sphenoid sinus neoplasias with close contact to the pituitary gland.

Value of Ga-67 SPECT in monitoring the effects of therapy in invasive aspergillosis of the sphenoid sinus

PURPOSE

We report a case of invasive sphenoid sinus aspergillosis clinically presenting as a pituitary mass.

METHODS

After exploration via the trans-sphenoidal approach and subsequent treatment with amphotericin-B, Ga-67 brain SPECT was performed twice to monitor the therapeutic effect.

RESULTS

Three months after antifungal treatment, Ga-67 brain SPECT showed partial resolution of the lesion in the sella turcica region. The patient continued with fluconazole treatment for another 2 months and received another Ga-67 brain SPECT, which showed complete clearing of the previous lesion.

CONCLUSION

Ga-67 brain SPECT may play a potentially useful role in monitoring the therapeutic effect of treatment of invasive sphenoid sinus aspergillosis.