Emerging and re-emerging infectious disease in otorhinolaryngology

SUMMARY

Emerging and re-emerging infectious disease in otorhinolaryngology (ENT) are an area of growing epidemiological and clinical interest. The aim of this section is to comprehensively report on the epidemiology of key infectious disease in otorhinolaryngology, reporting on their burden at the national and international level, expanding of the need of promoting and implementing preventive interventions, and the rationale of applying evidence-based, effective and cost- effective diagnostic, curative and preventive approaches. In particular, we focus on i) ENT viral infections (HIV, Epstein-Barr virus, Human Papilloma virus), retrieving the available evidence on their oncogenic potential; ii) typical and atypical mycobacteria infections; iii) non-specific granulomatous lymphadenopathy; iv) emerging paediatric ENT infectious diseases and the prevention of their complications; v) the growing burden of antimicrobial resistance in ENT and the strategies for its control in different clinical settings. We conclude by outlining knowledge gaps and action needed in ENT infectious diseases research and clinical practice and we make references to economic analysis in the field of ENT infectious diseases prevention and care.

Paranasal giant cell fibroblastoma: case report and immunohistochemical findings

Few published reports describe patients with giant cell fibroblastoma, a rare, benign soft-tissue tumor that recurs locally and predominantly arises in children. A 4-year-old boy underwent surgery for removal of a giant cell fibroblastoma in the paranasal region, an unusual site. Six months after excision the tumor recurred locally. Immunohistochemical examination of the primary tumor and recurrence revealed vimentin positive staining in the cytoplasm of all the cells. The multinucleated giant cells and the flat cells bordering the vessel-like spaces were negative for Factor VIII-related antigen, S-100 protein, actin and desmin. Some histiocytes stained positively for alpha-1-antitrypsin, alpha-1-antichymotrypsin, antimacrophage and lysozyme antibodies. These immunoreactions indicate that giant cell fibroblastomas have a fibrohistiocytic origin.

Acinic cell carcinoma of the parotid gland in childhood

A 13-year-old girl underwent surgery at the Ear Nose and Throat Department of the Children's Hospital and Scientific Research Institute, Bambino Gesù, Rome, because of an acinic cell carcinoma of the parotid gland. Two years after total parotidectomy with preservation of the facial nerve, metastasis occurred in a lateral cervical lymph node. Acinic cell tumors are uncommon in childhood; in children under the age of 16 years only 35 cases have been reported. There are too few acinar cell carcinomas occurring in children to yield an idea of their natural course. The neoplasm is also referred to as 'acinar cell tumor', in contrast to acinar cell carcinoma, because the neoplasm may be benign or malignant. Unfortunately, there are no histological distinguishing features that permit the pathologist to determine which neoplasm will behave in an aggressive fashion.

Cervical chordoma in childhood: clinical statistical contribution

Parapharyngeal neoplasias are rarely noticed in childhood, since they have their peak incidence between the 2nd and 4th decade of life. The authors report a case of a 4-year-old patient presenting with a retrostyloid mass, accompanied by nasal obstruction and some difficulty in swallowing at 12 months of age. CT scanning well ascertained the delimitation of the tumor, but it was of no help in the differential diagnosis. In fact, after surgical excision, the histological examination of the specimen revealed a chordoma. This result was unexpected because of the region concerned and the lack of a CT demonstration of the cervical boney involvement. A cervical vertebral localization of a chordoma is rare in all age groups and it is of particular clinical and statistical interest in infancy.