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Benign tumors

Among benign tumors of the nose and paranasal sinuses, papillomas, adenomas, vascular tumors, chondromas, and osteomas are of the greatest clinical importance. Many benign tumors show a tendency to malignancy over time. It has been noted that tumors of any degree of differentiation, localized on the lateral wall of the nose, should practically be regarded as potential malignant neoplasms (Karpov N.A., 1962).

Papilloma is a relatively rare tumor. Most often observed in people of older age groups. Three forms of papillomas are distinguished: mushroom-shaped, inverted, and transition-cell. The mushroom shape is located on the eve of the nose (nasal septum, bottom, inner surface of the wings of the nose) and resembles cauliflower in appearance. This is an absolutely benign tumor.

Inverted and transitional cell papillomas develop in the deep sections of the nose, mainly on its lateral wall. Transitional cell (cylindrical cell) papilloma comes from the respiratory epithelium of the nasal cavity. Inverted papilloma owes its name to the tendency to invagination of squamous epithelium in the form of a wide strip in the connective tissue (A. Kozlova et al., 1979). The surface of these tumors is smooth; upon examination, they resemble banal polyps. Papillomas grow slowly, manifested by a violation of nasal breathing through one of the halves of the nose. When they are injured, bleeding occurs. The last two forms of papillomas are prone to destructive growth, relapse and malignancy, which occurs in 4 to 5% of patients (Kozlova A.V. et al., 1979). According to V.S. Pogosov and V.F. Antoniv (1994), the malignancy of benign tumors, including papillomas, is promoted by radiation.

Adenoma is a rare tumor emanating from the glandular structures of the mucous membrane. It is also found mainly in old age. The tumor has a broad base, pink-gray color, covered with unchanged mucous membrane. Adenoma is characterized by slow growth, causing a gradual difficulty in nasal breathing. Malignancy of the adenoma is accompanied by its rapid growth, a change in the histological structure, germination in the surrounding tissues and adjacent cavities - paranasal sinuses, orbit and cranial cavity. Such a degeneration of adenoma, like papillomas, is characteristic of tumors localized on the lateral wall of the nose.

Vascular tumors (hemangioma and lymphangioma). These tumors are found at any age. There are capillary (from arterial vessels) and cavernous (venous) neoplasms. Lymphangiomas come from the lymphatic vessels. Vascular tumors can be located on the septum of the nose (medial wall of the nose), on the lateral wall and in any paranasal sinus.

Hemangiomas of the nasal septum are typical benign tumors. The hemangioma of this area is a small tumor of a round shape, sitting on a thin stalk or wider base in the anterior or middle third of the septum. The tumor has a bright red color, sometimes with a bluish tinge.
A characteristic symptom of hemangioma of the nasal septum is frequent, sometimes very significant bleeding from the corresponding half of the nose. A less disturbing and later symptom is the increasing difficulty in breathing in one of the halves of the nose. Hemangiomas are the most demonstrative example of the dependence of the course of the tumor process on localization (Karpov N.A., 1962). You should always keep in mind that hemangiomas located on the lateral wall of the nose have an increased tendency to malignancy.

Diagnosis of hemangiomas, characterized by a characteristic appearance, a tendency to bleeding, does not cause difficulties.

Chondroma. This tumor develops from the remnants of premordial cartilage. It occurs in adolescence and adulthood. It can come from the walls of the nasal cavity, as well as from the paranasal sinuses. The tumor is characterized by slow expansive and often infiltrating growth towards the orbits and into the cranial cavity. Chondroma often recurs and malignant if the operation was not radical enough. At the same time, inexorable growth is observed, accompanied by deformation of the facial skeleton and destruction of the surrounding anatomical formations, which leads to deep disturbances incompatible with life.

Osteoma. The most common benign tumor emanating from bone tissue and characterized by slow growth. The preferred place for its development is the frontal sinus, as well as the ethmoid labyrinth. The cause of osteoma development remains unknown. Histologically at the periphery, it is a dense plate bone, and in the central part it is a spongy bone. In most cases, the osteoma has a broad base. Gradually increasing in size, the tumor fills the paranasal sinus, causing headaches and deformation of the walls, which gradually increase displaces the eyeball. Possible violation of lacrimation. Clinical and radiological diagnosis of osteomas in most cases is not difficult (Figure 2.11.1).

The treatment of benign tumors is surgical. In cases where the tumor tends to become malignant, it should be removed as radically as possible. Removal of limited soft tissue tumors of the nasal septum is supplemented by electrocoagulation of the initial site or treatment with a cryoapplicator. ENT oncologists prefer to excise the tumor with a laser beam. Tumors located on the lateral wall of the nose and paranasal sinuses are removed radically using operations such as Denker or Moore. The greatest difficulty is the radical removal of chondroma located in the deep sections of the nasal cavity and base of the skull. The smallest remnant of non-removed chondroma leads to relapse, the first signs of which require urgent reoperation. Removal of the frontal sinus and ethmoid labyrinth by osteomas is performed through typical accesses and can present known difficulties only if they are significant and spread in the direction of the cranial cavity.
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Benign tumors

  1. Benign tumors are cured by poisons
    Benign tumors consist of cells that differ from normal ones mainly only by enhanced growth. Such tumors are characterized by limited enhanced growth, are often covered with a connective tissue capsule, and do not grow into surrounding tissues. In rare cases, benign tumors reach gigantic sizes (up to 10-20 kg), but even then they do not spread throughout the body. Clinically
  2. Benign ear tumors
    Ear tumors are rare diseases. There are benign and malignant neoplasms. Benign ear tumors include papillomas, fibromas, angiomas, chondromas, osteomas, etc. Of the tumor-like formations, various cysts (atheromas, dermoids, etc.) should be noted. Benign tumors are localized mainly in the outer ear.
  3. Benign Gastric Tumors
    formed as a result of inflammatory-reactive hyperplasia of the mucosa. Tumors are fibroepithelial, less commonly fibroids, fibroids, neuromas, angiomas, lipomas, hemangiomas. Polyps - conditionally benign tumors, are single or multiple formations located mainly in the antrum
  4. Benign Nasal Tumors
    Benign nasal tumors include papillomas, fibromas, angiomas and angiofibromas, chondromas, osteomas, neuromas, nevi (pigmented tumors), warts. Some authors referred to benign tumors and mucous polyps, however, these formations do not have a tumor structure and represent inflammatory and allergic hyperplasia of the mucous membrane, the so-called "singing
  5. Benign laryngeal tumors
    Among benign tumors of the larynx, fibromas, papillomas, and angiomas are more common. Fibroma (fibrous polyp) usually occurs at the free edge of the vocal fold at the border between the anterior and middle thirds, grows very slowly and often does not reach large sizes. It has a rounded shape, the base can be wide or in the form of legs. The histological structure of fibroma is presented
  6. Benign Ovarian Tumors
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  7. Benign Ovarian Tumors
    Benign tumors of the ovaries are divided into: • epithelial; • connective tissue. Epithelial neoplasms of the ovaries usually include: • serous: o smooth-walled; o papillary. • mucinous tumors: o proper cystomas or pseudo-mucinous cystomas o pseudomyxomas. The main type of connective tissue benign tumor is ovarian fibroma.
  8. Benign pharyngeal tumors
    Benign pharyngeal tumors include fibroma, papilloma, hairy polyp, angioma, neurinoma, neurofibroma, mixed tumors, lipoma, cysts, pharyngeal goiter. More often than others, papillomas and fibromas on the leg are found. Papillomas are usually soft, located on the soft palate and palatine arches, are small in size and, as a rule, bother the patients a little. In some cases, papillomas come from
  9. Benign liver tumors
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  10. Benign Neurogenic Tumors of the Ear
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  11. Benign tumors
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  12. Benign laryngeal tumors
    Laryngeal fibroma is in first place among all benign tumors of the larynx. It occurs equally often in men and women aged 20-50 years, in children is extremely rare. Usually they grow on the free edge along the upper surface of the vocal fold, have a dark cherry (sometimes lighter) color, as a rule it is single, mobile (Fig. 4.18). Its size is from lentil grains to peas. Complaints
  13. Benign Epithelial Tumors
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  14. Benign tumors without characteristic localization
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  15. Benign tumors with characteristic localization
    1. The villous adenoma of the colon. Often found in the colon. Macroscopic picture: looks like a large polyp (usually more than 1 cm) on a stalk or wide base (often has a villous surface). Microscopic picture: the adenoma is represented by numerous long papillae (villi) formed by highly differentiated epithelium with a large number
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