Background This study aims to describe the relationship between the new tumor nodes metastasis (TNM) staging and World Health Organization (WHO) classification and to identify how these two variables relate to each other and whether they possess a prognostic value in predicting survival and recurrence of disease. Methods Medical records of 54 patients who underwent surgery for thymic epithelial tumors between 1996 and 2015 were reviewed.The histologic type of neoplasm was classified according to the criteria of WHO and staging was evaluated using the new TNM classification system. Results A significant correlation between the TNM stages and the histological classification was found (p < 0.001). Complete resection is related to both TNM stage and histological grading (p < 0.001). Evaluation of the 5- and 10-year survival curves shows how these are significantly correlated only at the stage (p = 0.03 and = 0.04, respectively). The risk of death at 5 and 10 years for stages III to IV is six and three times higher than in stages I to II, respectively. Regarding the disease-free survival, there is significant correlation with both staging and histology (p = 0.001 and = 0.02, respectively). Conclusions There is a significant correlation between the new TNM staging and the histological grade WHO. The ability to implement a complete resection, the overall and disease-free survival is closely related to the thymoma stage. Furthermore, both histotype and stage correlate with disease-free survival. In fact, the least aggressive stages, both WHO and TNM, have a free time out of disease superior to advanced stages.

ObjectiveTo report on the results of intracanalicular vestibular schwannomas (ICVS) that were managed by wait and scan and to analyze the possible predictors of tumor growth and hearing deterioration throughout the observation period.Study DesignA retrospective case series.SettingQuaternary referral center for skull base pathologies.PatientsPatients with sporadic ICVS managed by wait and scan.InterventionSerial resonance imaging (MRI) with size measurement and serial audiological evaluation.Main Outcome MeasureTumor growth defined as 2 mm increase of maximal tumor diameter, further treatment, and hearing preservation either maintain initial modified Sanna hearing class, or maintain initial serviceable hearing (class A/B).Results339 patients were enrolled. The mean follow-up was 36.5±31.7 months with a median of 24 months. Tumor growth occurred in 141 patients (40.6%) either as slow growth (SG) in 26.3% of cases or fast growth (FG) in 15.3% of cases. Intervention was performed in only 64 cases (18.8%). Out of 271 patients who underwent hearing analysis, 86 patients (33.5%) showed hearing deterioration to a lower hearing class of the modified Sanna classification. Tumor growth and older age were predictors of hearing deterioration. Of the 125 cases with initial serviceable hearing (Class A/B), 91 cases (72.8%) maintained serviceable hearing at last follow-up. Tumor growth and a worse initial pure tone average (PTA) were predictors of hearing deterioration.ConclusionsWait and scan management of ICVS is a viable option and only 18.8% of patients needed further treatment. Hearing tends to deteriorate over time.

Obstructive Sleep Apnea (OSA) is a serious and underestimated respiratory sleep disorder that affects approximately 24% of men and 9% of women, and over a billion people worldwide [...]

Laryngeal tuberculosis (LTB) is a rare manifestation of tuberculosis (TB), accounting for 1% of all TB cases. Despite its rarity it is the most frequent laryngeal granulomatous disease. We performed a systematic literature review of the last 20 years on LTB and also present a case from our hospital with special focus on voice assessment. The literature review includes a total of 308 cases, involving studies from seven countries. In all, 64.3% of patients were males. At the time of diagnosis, the mean age range was 44.6-56.5 years. Odynophagia, hoarseness and dysphonia were the most frequent presenting symptoms. In 64 cases, the initial suspicion was laryngeal cancer. Most cases involved the true vocal folds. In about a third of cases a primary LTB with normal chest radiographic was found. Although it can be treated successfully, LTB may cause significant changes in voice quality. Nowadays, LTB is rarely diagnosed and may be confused with laryngeal cancer, it should also be included in the differential diagnosis with all other chronic benign inflammatory and non-inflammatory diseases of the larynx.

Rationale: The aim of this study is to describe a rare case of clear-cell renal cell carcinoma (ccRCC) metastasis to the pterygomaxillary fossa. Patient Concerns: A 54-year-old woman was referred to the Department of Otolaryngology due to right facial pain for the past six weeks. Diagnosis: ccRCC metastasis to the pterygomaxillary fossa. Treatment: The patient was treated by immunotherapy (Ipilimumab + Nivolumab) after multidisciplinary team evaluation. Outcomes: After 18 months, the patient is in good overall condition and the size of the skull base lesion has significantly reduced. Take-Away Lessons: ccRCC metastasis to the skull base and adjacent sites occur rarely. Most commonly, the presenting symptoms of these lesions are headache and diplopia for skull base metastases and epistaxis in case of sinusal involvement, according to the literature. When total resection of the metastasis is not feasible, tumour-targeted therapy may be used, as in the presented case. A multidisciplinary evaluation is recommended for the correct assessment and management of these patients.