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Metastasis of lung cancer to the skin is uncommon, presenting in 0.22% to 12% of lung cancer patients, and it is extremely rare for skin metastasis to be the first clinical manifestation of lung cancer. In the few cases where skin metastasis has been reported as the first sign of lung cancer, the patients were typically heavy smokers or had preexisting respiratory diseases and symptoms. This prompted clinicians to consider skin metastasis of a pulmonary malignancy. Large cell neuroendocrine carcinoma (LCNEC) is a rare type of lung cancer that accounts for approximately 3% of lung cancers. LCNEC mainly metastasizes to visceral organs, such as the liver, bone, and brain, and it only shows metastasis to the skin in very rare cases. Herein, we report an unusual case of a metastatic skin lesion as the first sign of primary pulmonary LCNEC, in a 63-year-old woman with no pulmonary symptoms or personal history of smoking or pulmonary disease.
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Background@#Mandibular split fractures, in which the fracture occurs exclusively in the posterior wall, are uncommon. This study aimed to enhance clinicians’ understanding of mandibular split fractures and offer insights for future research. @*Methods@#This study included six patients who visited our hospital between January 2020 and June 2023 and were diagnosed with mandibular split fractures. We retrospectively collected data from patients’ medical records on their age, sex, symptoms, mechanism, impact site, associated injuries, and treatment method, as well as the location, pattern, and number of fractures observed on computed tomography (CT) and panoramic images. The frequency of split fractures among all mandibular fractures was calculated. @*Results@#The six patients included three men (50%) and three women (50%), ranging in age from 20 to 71 years (mean age, 49.8 years). The split fractures were located in the symphysis in one patient (16.7%), symphysis to parasymphysis in two patients (33.3%), parasymphysis in one patient (16.7%), and parasymphysis to the body in two patients (33.3%). Four patients (66.7%) had condylar head fractures, while two patients (33.3%) had single split fractures. The mechanism of trauma was a slip-down incident in four cases (66.7%), while two cases (33.3%) were caused by motorcycle traffic accidents. Four patients (67%) underwent intermaxillary fixation, while two patients (33%) improved with conservative treatment. Split fractures were diagnosed in all six patients on CT, whereas the fracture line was not clearly visible on panoramic images. Mandibular split fractures accounted for 5.6% of all mandibular fractures. @*Conclusion@#This study provides insights into the clinical characteristics of rare mandibular split fractures and the diagnostic imaging findings. Furthermore, CT scans and three-dimensional image synthesis-instead of panoramic images-may be essential for accurately diagnosing mandibular fractures, including mandibular split fractures, in the future.
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Background@#Nasal bone fractures are frequently encountered in clinical practice. Although fracture reduction is simple and correction requires a short operative time, low patient satisfaction and relatively high complication rates remain issues for many surgeons. These challenges may result from inaccuracies in fracture recognition and assessment or inappropriate surgical planning. Findings from immediate postoperative computed tomography (CT) scans and those performed at 4 to 6 weeks postoperatively were compared to evaluate the accuracy and outcomes of nasal fracture reduction. @*Methods@#This retrospective study included patients diagnosed with nasal bone fractures at our department who underwent closed reduction surgery. Patients who did not undergo additional CT scans were excluded from the study. Clinical examinations, patient records, and radiographic images were evaluated in 20 patients with nasal bone fractures. @*Results@#CT findings from immediately after surgery and a 1month follow-up were compared in 20 patients. Satisfactory nasal projection and aesthetically acceptable results were observed in patients with accurate correction or mild overcorrection, while undercorrection was associated with unfavorable results. @*Conclusion@#Closed reduction surgery for correcting nasal bone fractures usually provides acceptable outcomes with relatively few complications. If available, immediate postoperative CT scans are recommended to guide surgeons in the choice of whether to perform secondary adjustments if the initial results are unsatisfactory. Based on photogrammetric data, nasal bone reduction with accurate correction or mild overcorrection achieved acceptable and stable outcomes at 1 month postoperatively. Therefore, when upward dislocation is observed on postoperative CT, one can simply observe without a subsequent intervention.
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Background@#Nasal bone fractures are frequently encountered in clinical practice. Although fracture reduction is simple and correction requires a short operative time, low patient satisfaction and relatively high complication rates remain issues for many surgeons. These challenges may result from inaccuracies in fracture recognition and assessment or inappropriate surgical planning. Findings from immediate postoperative computed tomography (CT) scans and those performed at 4 to 6 weeks postoperatively were compared to evaluate the accuracy and outcomes of nasal fracture reduction. @*Methods@#This retrospective study included patients diagnosed with nasal bone fractures at our department who underwent closed reduction surgery. Patients who did not undergo additional CT scans were excluded from the study. Clinical examinations, patient records, and radiographic images were evaluated in 20 patients with nasal bone fractures. @*Results@#CT findings from immediately after surgery and a 1month follow-up were compared in 20 patients. Satisfactory nasal projection and aesthetically acceptable results were observed in patients with accurate correction or mild overcorrection, while undercorrection was associated with unfavorable results. @*Conclusion@#Closed reduction surgery for correcting nasal bone fractures usually provides acceptable outcomes with relatively few complications. If available, immediate postoperative CT scans are recommended to guide surgeons in the choice of whether to perform secondary adjustments if the initial results are unsatisfactory. Based on photogrammetric data, nasal bone reduction with accurate correction or mild overcorrection achieved acceptable and stable outcomes at 1 month postoperatively. Therefore, when upward dislocation is observed on postoperative CT, one can simply observe without a subsequent intervention.
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Superficial angiomyxoma (SA) is a rare, benign, cutaneous soft tissue tumor. It is composed of myxoid matrix and blood vessels. Herein, we report a case of a solitary SA on the posterior neck of a 6-year-old boy. An analysis of the biopsied specimen showed a prominent myxoid stroma with thin-walled, branching blood vessels, revealing the presence of an SA. SA especially that originating in the posterior neck, is rarely seen and should be considered as a differential diagnosis for a solitary mass in the posterior neck.
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No Abstract Available.
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Histiocytic necrotizing lymphadenitis that causes unusual lymphadenopathy is a newly recognized disease of unknown etiology and may be mistaken for other conditions such as malignant lymphoma and tuberculosis, in which specific treatment will be required. Local lymph node enlargement especially in neck is the only characteristic feature, sometimes accompanied by pain, tenderness, fever and chill like a cold, nausea, vomiting. Laboratory investigations are usually noncontributory with an occasional case showing leukopenia or an elevated erythrocyte sedimentation rate. For further understanding of this disease and helping make diagnosis, clinical features were reviewed in 15 patients (29 lymph node enlargement), who were diagnosed as histiocytic necrotizing lymphadenitis on clinical evaluation (9 patients) or excisional biopsy (6 patients). The results are as follows; Disease was more common in female(1:2) and young patient. It involved left sided neck nodes frequently (67%) and the most common site was suboccipit-al triangle (62%). 47% of patient showed multiple enlargement of lymph nodes and the size of nodes were varied from 8 to 23 mm (mean: 12.4 mm). Most nodes were movable and showed oval in shape. Fever (47%), pain (33%), tenderness (53%), recent history of upper respiratory infection (33%), leukopenia (47%) and increased erythrocyte sedimentation rate (67%) were showed in many cases. Ultrasonogrphic and CT scan showed well defined oval to round lymph nodes enlargement with inhomogenous enhancement. All affected nodes are resolved spontaneously within 3-10 weeks (mean 5.1 weeks) without specific treatment. After reviewing all of above results, it is concluded that histiocytic necrotizing lymphadenitis is self-limiting disease without characteristic clinical features, but some factors like fever, pain, tendrness, leukopenia and increased erythrocyte sedimentation rate with cervical lymphadenopathy in young female patient are thought to be very helpful in diagnosis and in these circumstances, lymph node biopsy must be delayed for 2-3 months.
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Feminino , Humanos , Biópsia , Sedimentação Sanguínea , Diagnóstico , Febre , Linfadenite Histiocítica Necrosante , Leucopenia , Linfonodos , Doenças Linfáticas , Linfoma , Náusea , Pescoço , Tomografia Computadorizada por Raios X , Tuberculose , VômitoRESUMO
Traumatic loss of a finger in part or in which inevitably leads to significant functional deficit and a distortion in body image of the inflicted individual. The available reconstructive option in these circumstances have been toe to finger transfer using microsurgical technique, flap coverage after bone graft, and osteodistraction of the remnant finger. Each method carries advantages and drawbacks inherent in the technique, and generally requires long operative time and hospitalization. Furthermore, the postoperative results after such procedures can be said to be less satisfactory in aesthetic perspectives. Apart from the toe to finger transfer, not much can be sought in terms of functional recovery of the reconstructed part, For a long time finger prosthesis have been used as a replacement of the lost finger part, but it fails to deliver functional strength and tends to be dislodged rather easily. To overcome these shortcomings in the technique, an osseointegrated finger prosthesis has recently been devel-oped. Thumb, index and middle finger in 3 patients were reconstructed with this osseointegrated finger prosthesis. The procedure requires two procedures; the first stage involves placement of a titanium screw in the phalangeal or metacarpal bone proper, followed by fixation of an abutment onto the titanium screw 3 months after the primary operation. The skin surrounding the abutment is thinned out to minimize mobility of the prosthesis at this second stage of operation. After wound stabilization in 2-3 weeks, a custom-made silicone finger prosthesis is made and attached to the implanted abutment using super power magnets. The entire procedure requires 4 months up to the completion, but the procedures can be carried out on the outpatient basis under local anesthesia, not having to interfere with the daily activities of the patient. The aesthetic results with osseoperception have been found to be rewarding, and usual activity like a hand writing and typewriting have been possible. This alternative method could be used for finger reconstruction in cases of usual reconstructive surgery being impossible.