Giant cell tumors (GCT) of the bone are uncommon primary bone neoplasms that occur mainly in the epiphyses of long bones. However, GCT with tumoral growth in the cranium is rarely encountered, particularly in the temporal bone. GCT demonstrates benign histological features but is locally aggressive, and surgical excision is the treatment of choice. The authors describe a 31-year-old man who presented with trismus and an extensive GCT, which originated in the petrous and squamous portions of the temporal bone and extended into the left mandibular ramus and middle ear. He was treated by en bloc resection of the tumor by left temporal craniectomy using an extended pterional approach and canal wall down mastoidectomy. In addition to the description of this unusual case of GCT of the temporal bone presenting with trismus, a review of the related literature is included.

Primary squamous cell carcinoma (SCC) of the thyroid is an unusual neoplasm. Recently, a new theory has been expounded suggesting that papillary thyroid carcinoma has an SCC component, as squamous differentiation is detected in only a portion of papillary thyroid carcinomas. We experienced two cases of primary squamous cell carcinoma of the thyroid. One case was an 82-year-old woman who underwent a total thyroidectomy. Histopathologic findings revealed that the squamous cell carcinoma was extended to the soft tissue. The woman was treated with postoperative radiotherapy, but her prognosis was poor. On the other hand, the case of a 31-year-old woman who was diagnosed with squamous cell carcinoma and papillary carcinoma within the thyroid displayed good prognosis. We review the literature and discuss these two cases that bring into focus the different prognoses.

Primary cutaneous adenosquamous carcinomas are very rare with only few published reports. The histopathologic finding consists of two different components -mucin secreting cells (adenocarcinoma) and squamous cells (squamous cell carcinoma). We experienced a case of occipital scalp adenosquamous carcinoma, which is an extremely rare neoplasm in scalp. The lesion is histologically distinctive because of the presence of mixed areas of unequivocal adenocarcinoma and squamous cell carcinoma. It is found that combined surgery and additional radiation therapy is necessary because the biological behavior and prognosis of this neoplasm are considered as more aggressive and worse than that of conventional squamous cell carcinoma.

A unilateral thyroid agenesis that is found coexisting with a huge nodular goiter is very rare. We present a 43-year old woman with a recent history of a respiratory difficulty and a painless mass in the right side of her lower neck. A CT scan of her neck showed a 9×5 cm sized solid mass in the right infra-thyroid and thoracic area and left thyroid agenesis. The patient underwent surgery. The mass was identified as a structure separated from the right lobe of the thyroid, compressing the trachea. The histology revealed it to be a nodular goiter. The patient had an uneventful postoperative recovery and subsequently indicated euthyroid with normal normal calcium levels.

Background and ObjectivesZZThe aim of this study was to compare endoscopic endonasal transsphenoidal hypophysectomy (EETSA) with microscopic transseptal transsphenoidal hypophysectomy (MTTSA) in terms of clinical results during an acceleration of learning curve. Subjects and MethodZZA retrospective chart review was performed of the first 14 cases of EETSA and previous 14 cases of MTTSA. Resection results, endocrinologic outcomes, complication rates, operating time, and duration of hospital stay were investigated. A non-parametric analysis was performed to determine the significance of differences between groups. ResultsZZEETSA was performed, achieving gross total removal, based on postoperative MRI, for 12 of the 14 patients (86%) and hormonal remission for 4 of the 5 patients (80%); on the other hand, MTTSA was performed, achieving gross total removal for 9 of the 14 patients (64%) and hormonal remission for 1 of the 5 patients (20%). We found better resection results in patients who underwent EETSA than in those who did MTTSA with respect to tumors extending into suprasellar area (p＜0.05). Visual improvement was achieved in all the cases with visual defect (n=5) after EETSA, whereas 4 of 6 cases (66%) were improved after MTTSA. Significant differences in complication rates, operating time and hospital stay could not be determined. All cases with CSF leakage in EETSA were successfully managed by using the nasoseptal flap. ConclusionZZEETSA provided better resection results than MTTSA did, especially in cases extending into the suprasellar area, showing good hormonal cure and visual improvement rates. Two approaches were comparable with respect to complications during the learning curve.