RESUMO
Solitary fibrous tumor (SFT) is a rare type of mesenchymal neoplasm. Although the majority of SFTs are benign, some cases have shown characteristics of malignant neoplasms. Weight loss, fatigue, and upper abdominal bloating are the main signs of these lesions. Clinical and radiographic features are not sufficient for the diagnosis of hepatic SFT and the definitive diagnosis depends on histopathological sampling and immunohistochemistry. One of the main issues in the diagnosis of this tumour is the ability of this tumour to grow to large sizes.A 69-year-old male presented to the clinic 2 years earlier with episodes of hypoglycemia and loss of consciousness. The symptoms improved after receiving glucose. The patient diagnosed as rare solitary fibrous tumour of the liver, a giant (10 × 10 cm in diameter) round and well-defined lesion in the left lobe of the liver which was obvious in magnetic resonance imaging (MRI). Surgery isthe most common line of treatment for this disease and there is no evidence regarding the effectiveness of other approaches. According to the scarcity of hepatic SFT, long-term prognosis in these patients is highly challenging. Here, we present the case of a 69-year-old male patient with hepatic SFT with metastasis and local recurrence. In the very rare malignant form of liver solitary fibrous tumour which is surgically unresectable, liver transplantation is one of the potential options but maybe not amenable due to the malignant behaviour of the disease. Role of debulking surgery is also not clear in this situation
RESUMO
BACKGROUND: Oronasal/antral communication, loss of teeth and/or tooth-supporting bone, and facial contour deformity may occur as a consequence of maxillectomy for cancer. As a result, speaking, chewing, swallowing, and appearance are variably affected. The restoration is focused on rebuilding the oronasal wall, using either flaps (local or free) for primary closure, either prosthetic obturator. Postoperative radiotherapy surely postpones every dental procedure aimed to set fixed devices, often makes it difficult and risky, even unfeasible. Regular prosthesis, tooth-bearing obturator, and endosseous implants (in native and/or transplanted bone) are used in order to complete dental rehabilitation. Zygomatic implantology (ZI) is a valid, usually delayed, multi-staged procedure, either after having primarily closed the oronasal/antral communication or after left it untreated or amended with obturator. The present paper is an early report of a relatively new, one-stage approach for rehabilitation of patients after tumour resection, with palatal repair with loco-regional flaps and zygomatic implant insertion: supposed advantages are concentration of surgical procedures, reduced time of rehabilitation, and lowered patient discomfort. CASES PRESENTATION: We report three patients who underwent alveolo-maxillary resection for cancer and had the resulting oroantral communication directly closed with loco-regional flaps. Simultaneous zygomatic implant insertion was added, in view of granting the optimal dental rehabilitation. CONCLUSIONS: All surgical procedures were successful in terms of oroantral separation and implant survival. One patient had the fixed dental restoration just after 3 months, and the others had to receive postoperative radiotherapy; thus, rehabilitation timing was longer, as expected. We think this approach could improve the outcome in selected patients.