RESUMO
Abstract Objective: Oral Squamous Cell Carcinoma (OSCC) is conventionally treated by surgical resection, and positive surgical margins strongly increase local recurrence and decrease survival. This study aimed to evaluate whether a Three-Dimensional Segmentation (3DS) image of OSCC confers advantage over Multiplanar Reconstruction (MPR) of OSCC using images of computed tomography scan in surgical planning of tumor resection. Methods: Twenty-six patients with locally advanced OSCC had tumor morphology and dimensions evaluated by MPR images, 3DS images, and Surgical Pathology Specimen (SPS) analyses (gold standard). OSCC resection was performed with curative intent using only MPR images. Results: OSCC morphology was more accurately assessed by 3DS than by MPR images. Similar OSCC volumes and dimensions were obtained when MPR images, 3DS images and SPS measurements were considered. Nevertheless, there was a strong correlation between the OSCC longest axis measured by 3DS and SPS analyses (ICC = 0.82; 95% CI 0.59-0.92), whereas only a moderate correlation was observed between the longest axis of OSCC measured by MPR images and SPS analyses (ICC = 0.51; 95% CI 0.09-0.78). Taking only SPS with positive margins into account, MPR images and 3DS images underestimated the tumor's longest axis in eight out of 11 (72.7%) and 5 out of the 11 (45.5%) cases, respectively. Conclusion: Our data present preliminary evidence that 3DS model represents a useful tool for surgical planning of OSCC resection, but confirmation in a larger cohort of patients is required. Level of evidence: Laboratory study.
RESUMO
A histiocitose de células de Langerhans é uma doença rara caracterizada proliferação de células de Langerhans. Neste artigo descrevemos um caso de histiocitose de células de Langerhans em um paciente de 63 anos, com uma lesão expansiva periorbital como primeiro sintoma e cuja tomografia computadorizada revelou acometimento pulmonar característico da doença. A condução do caso, os achados radiológicos e os resultados são apresentados.
Langerhans cell histiocytosis is a rare disease characterized by proliferation of Langerhans cells. We report a case of Langerhans cell histiocytosis in a 63-year-old patient, who presented an expansile periorbital lesion as the first symptom, in whom computed tomography revealed characteristic lung commitment of the disease. The case management, as well as radiological findings and outcomes are described.