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Background: Middle ear adenoma with neuroendocrine differentiation (MEA-ND), also known as carcinoid tumor of the middle ear, is an extremely rare neoplasm, especially when located within the tympanic cavity. To the best of our knowledge, this represents the first pediatric case of a MEA-ND described in Europe. Excluding the present case, only three other pediatric cases of this disease have been published globally. Case report: We report on a 15-year-old female patient who presented with conductive hearing loss of the right ear. A tympanogram was flat. Ear microscopy revealed bulging of the right posterior superior tympanic quadrant. Computed tomography depicted an opacification of the middle ear and mastoid air cells without evidence of bone erosion. Paracentesis was performed assuming a serous otitis media. Since there was no liquid found the patient underwent an atticoantrotomy and mastoidectomy as therapy for cholesteatoma. Histologic examination revealed a highly differentiated neuroendocrine tumor. Immunohistochemical evaluation showed strong positivity for synaptophysin. On the basis of these results, the patient underwent a middle ear revision surgery. After 15 months, magnetic resonance imaging and octreotide scans suggested disease recurrence, prompting a second surgical revision. The histologic examination confirmed a recurrence of only 1 mm, but postoperative imaging still showed pathological diffuse enhancement. Eight years after the initial diagnosis there has been no evidence of recurrence or metastasis. Conclusion: In our opinion a pathological radiological result is insufficient to identify recurrent or residual disease within the tympanic cavity. [ABSTRACT FROM AUTHOR]

Twenty-eight patients with a total of 32 stenoses of the renal artery were examined by angiography 6 months following percutaneous transluminal angioplasty (PTA). The angiograms were obtained: (1) prior to PTA; (2) immediately following PTA; and (3) 6 months later. These angiograms were compared and the relationship of diameter of the stenosis (A) to the poststenotic region (B) was evaluated. In 22 cases (78.5%), 6 months post-PTA, the stenoses were no longer demonstrated; stenosis diameter (A) showed an average increase from 2.1 to 5.1 mm, while the poststenotic region (B) decreased from 7.7 to 5.6 mm on average. Five cases of partial stenoses (17.8%) seen on angiograms 6 months after PTA still showed a marked difference between A and B, with only a minimal reduction in area of B. In five patients with restenosis (17.8%), nearly the same results were obtained as in the pre-PTA state. Neither aneurysms nor renal arterial obstruction was found in our patient group. Rather, in most of our patients normalization of the renal vessels could be demonstrated on angiograms, supporting the choice of PTA as the preferred method of treatment of renal artery stenosis. [ABSTRACT FROM AUTHOR]