ABSTRACT
La patología de la falange distal de los dedos de la mano es atendida con frecuencia en los Servicios de Urgencias de Atención Primaria. Se trata de procesos médico-quirúrgicos muy habituales y de fácil resolución. En el presente manuscrito se revisan la patología infecciosa y traumática de la falange distal de la mano que requieren un tratamiento quirúrgico que puede ser realizado sin problemas en cualquier Centro de Salud. Consideramos que en un ámbito de primer nivel mínimamente dotado se pueden llevar a cabo, en el área descrita, los siguientes procedimientos: drenajes de colecciones purulentas o hematomas subungueales, exéresis de la uña encarnada, fijación de una avulsión ungueal, sutura de heridas incisas que no afecten al aparato flexo-extensor o al paquete vascular, pérdidas de sustancia del pulpejo sin exposición ósea y si hay disponibilidad de equipo de rayos X, fijación de una fractura de penacho ungueal y el tratamiento conservador del dedo en martillo (AU)
Subject(s)
Finger Injuries/surgery , Minor Surgical Procedures/methods , Ambulatory Surgical Procedures/methodsABSTRACT
From 1986 to 1994, 61 patients with oral tongue epidermoid carcinoma were treated using low dose rate iridium brachytherapy. Eleven patients treated with combined external beam and brachytherapy and 8 with nodal metastases at presentation were excluded from the study. The results in 42 fully evaluable and regularly followed patients here retrospectively reviewed. In 22 cases clinical stage was T1 greater than 1 cm and in the remaining 20 T2, N0 M0; all were cases of epidermoid carcinoma. The patients received definitive brachytherapy to the primary site using plastic tube technique at a dose of 5067 Gy (median 60 Gy) at reference isodose. The dose rate ranged from 35 cGy/h to 80 cGy/h (median 53 cGy/h). Elective neck dissection was performed in 24 patients, whereas a surveillance protocol was adopted in the remaining 18 cases. After an average follow-up of 40 months, 5 year absolute and disease specific survival (Kaplan Meier) was 61% and 88% respectively. Two patients failed at the primary site (local control probability 96%). Nodal metastases were found in 6 of 24 electively dissected patients and developed subsequently in 3 of 18 pN0 cases and in 4 of 18 non dissected patients. Four patients died of uncontrolled neck disease (regional control probability 76%). A severe necrosis developed in 9 patients (soft tissue in 4 and bone in 5 patients), but only 3 cases required surgery. This study confirms brachytherapy as an effective treatment modality for the early stage of oral tongue carcinoma.
Subject(s)
Brachytherapy/methods , Carcinoma, Squamous Cell/therapy , Tongue Neoplasms/therapy , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Incidence , Iridium Radioisotopes , Italy/epidemiology , Male , Middle Aged , Neoplasm Staging , Radiation Dosage , Retrospective Studies , Survival Rate , Tongue Neoplasms/mortalityABSTRACT
The authors report a case of giant cell tumour of the mandibular condyle, which is a rare finding. This tumour, studied using the main three radiological modalities (plain radiography, CT and MRI) showed characteristic radiological features of "giant cell tumour".
Subject(s)
Giant Cell Tumor of Bone/diagnostic imaging , Mandibular Condyle/diagnostic imaging , Mandibular Neoplasms/diagnostic imaging , Adult , Biopsy , Female , Giant Cell Tumor of Bone/diagnosis , Giant Cell Tumor of Bone/pathology , Humans , Magnetic Resonance Imaging , Mandibular Condyle/pathology , Mandibular Neoplasms/diagnosis , Mandibular Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
The authors present a case of a giant cell tumor of the mandibular condyle, which is a very rare condition. Problems relating to diagnosis and treatment are examined. Specifically non neoplastic and neoplastic lesions in which giant cells are identified have been evaluated.
